Melanie D Talson, Priscila Ferreira da Silva, Juli Finlay, Krista Rossum, Kaytlynn V Soroka, Michael McCormick, Arlene Desjarlais, Hans Vorster, Rachelle Sass, Matthew James, Manish M Sood, Allison Jaure, Neesh Pannu, Karthik Tennankore, Stephanie Thompson, Marcello Tonelli, Clara Bohm
{"title":"改善血液透析中医患互动的患者、护理者和提供者观点：一项定性研究。","authors":"Melanie D Talson, Priscila Ferreira da Silva, Juli Finlay, Krista Rossum, Kaytlynn V Soroka, Michael McCormick, Arlene Desjarlais, Hans Vorster, Rachelle Sass, Matthew James, Manish M Sood, Allison Jaure, Neesh Pannu, Karthik Tennankore, Stephanie Thompson, Marcello Tonelli, Clara Bohm","doi":"10.1177/20543581241309986","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Improving interactions between people receiving hemodialysis and health care providers of facility-based hemodialysis care is a top priority for patients, caregivers, and health care providers.</p><p><strong>Objective: </strong>To identify challenges for high-quality clinical interactions in facility-based hemodialysis care as well as potential solutions.</p><p><strong>Design: </strong>Multicentre qualitative study using focus groups and semi-structured interviews to elicit the perspectives of patients, caregivers, and health care providers.</p><p><strong>Setting: </strong>Five Canadian facility-based hemodialysis centers.</p><p><strong>Participants: </strong>English-speaking adults receiving facility-based hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers.</p><p><strong>Methods: </strong>Between May 2017 and August 2018, focus groups and interviews with patients and their caregivers subsequently informed semi-structured interviews with providers. Data were analyzed using inductive thematic analysis with application of a grounded theory approach.</p><p><strong>Results: </strong>A total of 8 focus groups and 44 interviews were completed. Participants included 64 people receiving hemodialysis, 18 caregivers, and 31 health care providers. Communication between health care providers and patients was often characterized as <i>intersections</i> of care (unidirectional) rather than <i>interactions</i> (bidirectional). Challenges were grouped into 4 main themes as follows: (1) culture of care provision; (2) mistrust between patients and health care providers; (3) time constraints for clinical interactions, and (4) lack of collaboration and care coordination among health care team. Potential solutions were identified for each challenge.</p><p><strong>Limitations: </strong>Findings were limited to Canadian context, English-speaking adults, and individuals receiving facility-based hemodialysis in urban centers.</p><p><strong>Conclusions: </strong>Interactions between health care providers and people receiving dialysis are often unidirectional, where the patient is a passive recipient of ideas and information from the health care provider. To promote improved bidirectional interactions, team-based care that includes better tools to improve information transfer, better information regarding roles, and identity of health care team members and opportunities for all members of the health care team, including the people receiving dialysis, to provide input on care plans is required.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581241309986"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696963/pdf/","citationCount":"0","resultStr":"{\"title\":\"Patient, Caregiver, and Provider Perspectives on Improving Provider-Patient Interactions in Hemodialysis: A Qualitative Study.\",\"authors\":\"Melanie D Talson, Priscila Ferreira da Silva, Juli Finlay, Krista Rossum, Kaytlynn V Soroka, Michael McCormick, Arlene Desjarlais, Hans Vorster, Rachelle Sass, Matthew James, Manish M Sood, Allison Jaure, Neesh Pannu, Karthik Tennankore, Stephanie Thompson, Marcello Tonelli, Clara Bohm\",\"doi\":\"10.1177/20543581241309986\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Improving interactions between people receiving hemodialysis and health care providers of facility-based hemodialysis care is a top priority for patients, caregivers, and health care providers.</p><p><strong>Objective: </strong>To identify challenges for high-quality clinical interactions in facility-based hemodialysis care as well as potential solutions.</p><p><strong>Design: </strong>Multicentre qualitative study using focus groups and semi-structured interviews to elicit the perspectives of patients, caregivers, and health care providers.</p><p><strong>Setting: </strong>Five Canadian facility-based hemodialysis centers.</p><p><strong>Participants: </strong>English-speaking adults receiving facility-based hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers.</p><p><strong>Methods: </strong>Between May 2017 and August 2018, focus groups and interviews with patients and their caregivers subsequently informed semi-structured interviews with providers. Data were analyzed using inductive thematic analysis with application of a grounded theory approach.</p><p><strong>Results: </strong>A total of 8 focus groups and 44 interviews were completed. Participants included 64 people receiving hemodialysis, 18 caregivers, and 31 health care providers. Communication between health care providers and patients was often characterized as <i>intersections</i> of care (unidirectional) rather than <i>interactions</i> (bidirectional). Challenges were grouped into 4 main themes as follows: (1) culture of care provision; (2) mistrust between patients and health care providers; (3) time constraints for clinical interactions, and (4) lack of collaboration and care coordination among health care team. Potential solutions were identified for each challenge.</p><p><strong>Limitations: </strong>Findings were limited to Canadian context, English-speaking adults, and individuals receiving facility-based hemodialysis in urban centers.</p><p><strong>Conclusions: </strong>Interactions between health care providers and people receiving dialysis are often unidirectional, where the patient is a passive recipient of ideas and information from the health care provider. To promote improved bidirectional interactions, team-based care that includes better tools to improve information transfer, better information regarding roles, and identity of health care team members and opportunities for all members of the health care team, including the people receiving dialysis, to provide input on care plans is required.</p><p><strong>Trial registration: </strong>Not applicable.</p>\",\"PeriodicalId\":9426,\"journal\":{\"name\":\"Canadian Journal of Kidney Health and Disease\",\"volume\":\"12 \",\"pages\":\"20543581241309986\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-01-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696963/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Kidney Health and Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20543581241309986\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Kidney Health and Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20543581241309986","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Patient, Caregiver, and Provider Perspectives on Improving Provider-Patient Interactions in Hemodialysis: A Qualitative Study.
Background: Improving interactions between people receiving hemodialysis and health care providers of facility-based hemodialysis care is a top priority for patients, caregivers, and health care providers.
Objective: To identify challenges for high-quality clinical interactions in facility-based hemodialysis care as well as potential solutions.
Design: Multicentre qualitative study using focus groups and semi-structured interviews to elicit the perspectives of patients, caregivers, and health care providers.
Setting: Five Canadian facility-based hemodialysis centers.
Participants: English-speaking adults receiving facility-based hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers.
Methods: Between May 2017 and August 2018, focus groups and interviews with patients and their caregivers subsequently informed semi-structured interviews with providers. Data were analyzed using inductive thematic analysis with application of a grounded theory approach.
Results: A total of 8 focus groups and 44 interviews were completed. Participants included 64 people receiving hemodialysis, 18 caregivers, and 31 health care providers. Communication between health care providers and patients was often characterized as intersections of care (unidirectional) rather than interactions (bidirectional). Challenges were grouped into 4 main themes as follows: (1) culture of care provision; (2) mistrust between patients and health care providers; (3) time constraints for clinical interactions, and (4) lack of collaboration and care coordination among health care team. Potential solutions were identified for each challenge.
Limitations: Findings were limited to Canadian context, English-speaking adults, and individuals receiving facility-based hemodialysis in urban centers.
Conclusions: Interactions between health care providers and people receiving dialysis are often unidirectional, where the patient is a passive recipient of ideas and information from the health care provider. To promote improved bidirectional interactions, team-based care that includes better tools to improve information transfer, better information regarding roles, and identity of health care team members and opportunities for all members of the health care team, including the people receiving dialysis, to provide input on care plans is required.
期刊介绍：
Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.
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