A thematic synthesis of the experiences of adults living with hemodialysis

Reid, Claire; Seymour, Julie; Jones, Colin

Abstract

Background and objectives In-center dialysis patients spend significant amounts of time on the dialysis unit; additionally managing ESKD affects many aspects of life outside the dialysis unit. To improve the care provided to patients requiring hemodialysis their experiences and beliefs regarding treatment must be understood. This systematic review aimed to synthesise the experiences of patients receiving in-center hemodialysis. Design, setting, participants, and measurements Embase, MEDLINE, CINAHL and PsychINFO, Google scholar and reference lists were searched for primary qualitative studies exploring the experiences of adult patients receiving treatment with in-center hemodialysis. A thematic synthesis was conducted. Results 17 studies involving 576 patients were included in the synthesis. 4 analytical themes were developed. The first theme “a new dialysis dependent self” describes the changes in identity and perceptions of self that could result from dialysis dependence. The second theme, “a restricted life”, describes the physical and emotional constraints patients described as a consequence of their dependence. Some patients reported strategies that allowed them to regain a sense of optimism and influence over the future and these contributed to the third theme, “regaining control”. The first three themes describe a potential for change through acceptance, adaption and re-gaining a sense of control. The final theme, “relationships with health professionals” describes the importance of these relationships for in-center patients and their influence on perceptions of power and support. These relationships are seen to influence the other three themes through information sharing, continuity and personalized support. Conclusions This synthesis has resulted in a framework that can be utilized to consider interventions to improve patients’ experiences of in-center hemodialysis care. Focusing on interventions that are incorporated into the established relationships patients have with their health care professionals may enable patients’ to progress towards a sense of control and improve satisfaction with care.

Citation

Reid, C., Seymour, J., & Jones, C. (2016). A thematic synthesis of the experiences of adults living with hemodialysis. Clinical journal of the American Society of Nephrology, 11(7), 1206-1218. https://doi.org/10.2215/CJN.10561015

• Acceptance Date: Mar 16, 2016
• Online Publication Date: May 31, 2016
• Publication Date: Jul 7, 2016
• Deposit Date: Apr 20, 2016
• Publicly Available Date: May 31, 2016
• Journal: Clinical journal of the American Society of Nephrology
• Print ISSN: 1555-9041
• Electronic ISSN: 1555-905X
• Publisher: American Society of Nephrology
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 7
• Pages: 1206-1218
• DOI: https://doi.org/10.2215/CJN.10561015
• Keywords: Chronic kidney disease; Hemodialysis; Quality of life; Patient satisfaction; Patient experience; Renal replacement therapy; Qualitative research; Thematic synthesis
• Public URL: https://hull-repository.worktribe.com/output/436520
• Publisher URL: http://cjasn.asnjournals.org/content/early/2016/05/30/CJN.10561015.abstract
• Additional Information: This is the author's accepted manuscript of an article published in Clinical journal of the American Society of Nephrology, 2016, v.11 issue 7.