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Mehta K, Hussein WF, Leuther KK, Fegler A, Schiller B, Bennett PN. The experiences of people starting haemodialysis: A qualitative study. J Ren Care 2024. [PMID: 38734873 DOI: 10.1111/jorc.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND AND OBJECTIVE Starting dialysis is a life-changing transition for people living with kidney disease. People feel overwhelmed with diet changes, medications and surgical interventions, and often experience high levels of anxiety, depression and hospital admissions. The objective of this study was to explore and describe the experiences and perspectives of people starting dialysis. STUDY DESIGN Observational qualitative study using audio-recorded, individual, semi-structured interviews. PARTICIPANTS We conducted 20 semi-structured interviews with English-speaking adults who were within 90 days of starting in-centre haemodialysis at centres of a nonprofit dialysis provider in Northern California. APPROACH Trained qualitative researchers conducted interviews that were deidentified and transcribed verbatim before being inductively coded into codes, categories, and themes. RESULTS Three overarching themes emerged from the interviews. Being overwhelmed when starting dialysis, realises the emotional unpreparedness of patients starting dialysis and how the centre's environment (waiting and treatment areas) and staff behaviour impact the dialysis start experience. Making sense of it all, covers how the patient's symptoms, behaviour, and dialysis-related experiences impact the dialysis start. Moving forward, describes how education informed optimal decision-making, and can provide hope for a longer and better life. LIMITATIONS Predominantly college-educated participants were recruited from a single dialysis organisation which may limit the transferability of results. CONCLUSION Understanding the life-changing experiences that patients encounter when starting dialysis assist dialysis clinicians to help patients adjust and develop long-term coping strategies.
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Affiliation(s)
- Kshama Mehta
- Satellite Healthcare, Inc., San Jose, California, USA
- ImCare Biotechnology, Doylestown, Pennsylvania, USA
| | - Wael F Hussein
- Satellite Healthcare, Inc., San Jose, California, USA
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Kerstin K Leuther
- Satellite Healthcare, Inc., San Jose, California, USA
- Department of Clinical Research, University of Jamestown, Jamestown, North Dakota, USA
| | | | - Brigitte Schiller
- Satellite Healthcare, Inc., San Jose, California, USA
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Paul N Bennett
- School of Nursing and Midwifery, Griffith University, Queensland, Australia
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Xu T, Liu F, Cesario SK, Moore B. The lived experience of Chinese medical tourists receiving cancer care: A qualitative study. Nurs Open 2023. [PMID: 36917552 DOI: 10.1002/nop2.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
AIM The purpose of this study was to describe and explore the lived experience of Chinese medical tourists receiving cancer care in clinical settings in the United States. DESIGN A qualitative phenomenological design. METHODS In this study, Hermeneutic phenomenology was used to interview 11 participants on WeChat, a popular social media platform of China. Hermeneutic phenomenology methods and hermeneutic circles were used to analyse data. RESULTS Five themes identified were: the application process involves various challenges; overcoming transportation and language barriers; feeling content with healthcare received in the United States; nearly perfect experience, except for long waiting times; and high cost of being a medical tourist. CONCLUSION Despite the cost and complexity of cancer treatment, Chinese medical tourists valued their experience in US clinical settings. Although, they experienced real challenges, they overcame obstacles with self-determination and varied resources. Therefore, culturally appropriate healthcare is highly recommended. RELEVANCE TO CLINICAL PRACTICE The findings of this study are relevant for clinical practice, particularly cancer care to medical tourists in the United States. To better support the Chinese medical tourists with cancer, various strategies and techniques, as reported in this study, could be helpful. It is highly recommended to provide healthcare providers to enable them to understand and respect the diversity norms of other cultures.
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Affiliation(s)
- Tuzhen Xu
- College of Nursing, Texas Woman's University, Houston, TX, USA
| | - Fuqin Liu
- College of Nursing, Texas Woman's University, Houston, TX, USA
| | | | - Brenda Moore
- College of Nursing, Texas Woman's University, Houston, TX, USA
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Alilyyani B, Kerr M, Wong C, Wazqar D. A Psychometric Analysis of the Nurse Satisfaction with the Quality of Care Scale. Healthcare (Basel) 2022; 10:healthcare10061145. [PMID: 35742196 PMCID: PMC9222378 DOI: 10.3390/healthcare10061145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
The concept of quality of nursing care can vary across healthcare organizations, and many different factors may affect the quality of nursing care as perceived by nurses. Measuring satisfaction with quality of nursing care from the nurse’s perspective is important as a valid and reliable indicator of care quality. The purpose of this study was to measure the psychometric properties of a researcher-developed instrument measuring nurse satisfaction with quality of care. A sample of 200 nurses was randomly selected from three different cities in Saudi Arabia and surveyed with the Nurse Satisfaction with Quality of Care Scale, which is a self-administrated five-item scale. Exploratory factor analysis, confirmatory factor analysis, and internal consistency analysis were conducted to assess aspects of the validity and reliability of the instrument. The results of exploratory factor analysis supported a one-factor structure that consisted of the five items. Confirmatory factor analysis results confirmed that the five items were integral to nurse satisfaction with quality of care. The Cronbach internal consistency of the scale was acceptable. The scale appeared to be a reliable and valid tool for assessing nurse perceptions of their satisfaction with the quality of care provided. Additional studies to further test psychometric properties of this scale in different contexts are warranted.
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Affiliation(s)
- Bayan Alilyyani
- Nursing Department, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
- Correspondence: ; Tel.: +966-541012668
| | - Michael Kerr
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada; (M.K.); (C.W.)
| | - Carol Wong
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada; (M.K.); (C.W.)
| | - Dhuha Wazqar
- Faculty of Nursing, King Abdulaziz University, P.O. Box 24828, Jeddah 21551, Saudi Arabia;
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Nurses competence and hemodialysis adequacy achievement. ENFERMERIA CLINICA 2021. [PMID: 33849145 DOI: 10.1016/j.enfcli.2020.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Competence is defined as a combination of an individual's knowledge, attitude, and skills. Nurses, as the primary caregivers to hemodialysis patients, have an essential role in achieving hemodialysis adequacy. Hemodialysis adequacy achievement is one of the quality indicators of hemodialysis care. The research aims to identify the relationship between nurse competence and the achievement of hemodialysis in Bandung. The research design was correlation analytical with a cross-sectional method, which involved 82 hemodialysis nurses and 82 hemodialysis patients. Samples were using consecutive sampling. The data were analyzed using chi-square. The result shows that nurse's competence, especially nurse's attitude and skills in providing nursing care for hemodialysis patients, has a significant relationship with the achievement of hemodialysis adequacy. Nurses in the hemodialysis unit should improve their knowledge, attitude, and skills in providing nursing care.
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Roberti J, Cummings A, Myall M, Harvey J, Lippiett K, Hunt K, Cicora F, Alonso JP, May CR. Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies. BMJ Open 2018; 8:e023507. [PMID: 30181188 PMCID: PMC6129107 DOI: 10.1136/bmjopen-2018-023507] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/28/2018] [Accepted: 08/08/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) requires patients and caregivers to invest in self-care and self-management of their disease. We aimed to describe the work for adult patients that follows from these investments and develop an understanding of burden of treatment (BoT). METHODS Systematic review of qualitative primary studies that builds on EXPERTS1 Protocol, PROSPERO registration number: CRD42014014547. We included research published in English, Spanish and Portuguese, from 2000 to present, describing experience of illness and healthcare of people with CKD and caregivers. Searches were conducted in MEDLINE, Embase, CINAHL Plus, PsycINFO, Scopus, Scientific Electronic Library Online and Red de Revistas Científicas de América Latina y el Caribe, España y Portugal. Content was analysed with theoretical framework using middle-range theories. RESULTS Searches resulted in 260 studies from 30 countries (5115 patients and 1071 carers). Socioeconomic status was central to the experience of CKD, especially in its advanced stages when renal replacement treatment is necessary. Unfunded healthcare was fragmented and of indeterminate duration, with patients often depending on emergency care. Treatment could lead to unemployment, and in turn, to uninsurance or underinsurance. Patients feared catastrophic events because of diminished financial capacity and made strenuous efforts to prevent them. Transportation to and from haemodialysis centre, with variable availability and cost, was a common problem, aggravated for patients in non-urban areas, or with young children, and low resources. Additional work for those uninsured or underinsured included fund-raising. Transplanted patients needed to manage finances and responsibilities in an uncertain context. Information on the disease, treatment options and immunosuppressants side effects was a widespread problem. CONCLUSIONS Being a person with end-stage kidney disease always implied high burden, time-consuming, invasive and exhausting tasks, impacting on all aspects of patients' and caregivers' lives. Further research on BoT could inform healthcare professionals and policy makers about factors that shape patients' trajectories and contribute towards a better illness experience for those living with CKD. PROSPERO REGISTRATION NUMBER CRD42014014547.
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Affiliation(s)
- Javier Roberti
- FINAER, Foundation for Research and Assistance of Kidney Disease, Buenos Aires, Argentina
| | - Amanda Cummings
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Michelle Myall
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Jonathan Harvey
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Kate Lippiett
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Katherine Hunt
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Federico Cicora
- FINAER, Foundation for Research and Assistance of Kidney Disease, Buenos Aires, Argentina
| | - Juan Pedro Alonso
- Faculty of Social Sciences, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carl R May
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
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Sharafi S, Chamanzari H, Pouresmail Z, Rajabpour M, Bazzi A. The Effect of Case Method and Primary Nursing Method on the Social Dimension in Quality of Patient Care. JOURNAL OF HOLISTIC NURSING AND MIDWIFERY 2018. [DOI: 10.29252/hnmj.28.4.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Experience of Nurses in Hemodialysis Care: A Phenomenological Study. J Clin Med 2018; 7:jcm7020030. [PMID: 29439484 PMCID: PMC5852446 DOI: 10.3390/jcm7020030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 02/02/2018] [Accepted: 02/06/2018] [Indexed: 12/02/2022] Open
Abstract
This study aimed to describe the experiences of nurses in hemodialysis care. In this phenomenological study, purposive sampling began and continued until data saturation. The research environment was the Hemodialysis unit. Data was collected through semi-structured interviews. Finally, two main classes and four sub-classes were identified, including factors effective on care (inhibitors and facilitators) and care outcomes (the negative effects of care on the nurse and the positive effects of care on the patient), and “challenging care” as the main theme. As the results show, nurses suffer from several physical and mental harm, and this harm even extends to their family environment, and their families are indirectly affected by the negative effects of this care. Therefore, strengthening management approaches to eliminate the inhibitor factors is essential in order to prevent nurses’ burnout or quitting while improving the quality of care provided by them.
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