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Ferreira da Silva P, Talson MD, Finlay J, Rossum K, Soroka KV, McCormick M, Desjarlais A, Vorster H, Fontaine G, Sass R, James M, Sood MM, Tong A, Pannu N, Tennankore K, Thompson S, Tonelli M, Bohm C. Patient, Caregiver, and Provider Perspectives on Improving Information Delivery in Hemodialysis: A Qualitative Study. Can J Kidney Health Dis 2021; 8:20543581211046078. [PMID: 34721884 PMCID: PMC8552378 DOI: 10.1177/20543581211046078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background Patients with kidney failure are exposed to a surfeit of new information about their disease and treatment, often resulting in ineffective communication between patients and providers. Improving the amount, timing, and individualization of information received has been identified as a priority in in-center hemodialysis care. Objective To describe and explicate patient, caregiver, and health care provider perspectives regarding challenges and solutions to information transfer in clinical hemodialysis care. Design In this multicenter qualitative study, we gathered perspectives of patients, their caregivers, and health care providers conducted through focus groups and interviews. Setting Five Canadian hemodialysis centers: Calgary, Edmonton, Winnipeg, Ottawa, and Halifax. Participants English-speaking adults receiving in-center hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers. Methods Between May 24, 2017, and August 16, 2018, data collected through focus groups and interviews with hemodialysis patients and their caregivers subsequently informed semi-structured interviews with health care providers. For this secondary analysis, data were analyzed through an inductive thematic analysis using grounded theory, to examine the data more deeply for overarching themes. Results Among 82 patients/caregivers and 31 healthcare providers, 6 main themes emerged. Themes identified from patients/caregivers were (1) overwhelmed at initiation of hemodialysis care, (2) need for peer support, and (3) improving comprehension of hemodialysis processes. Themes identified from providers were (1) time constraints with patients, (2) relevance of information provided, and (3) technological innovations to improve patient engagement. Limitations Findings were limited to Canadian context, English speakers, and individuals receiving hemodialysis in urban centers. Conclusions Participants identified challenges and potential solutions to improve the amount, timing, and individualization of information provided regarding in-center hemodialysis care, which included peer support, technological innovations, and improved knowledge translation activities. Findings may inform the development of interventions and strategies aimed at improving information delivery to facilitate patient-centered hemodialysis care.
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Affiliation(s)
| | - Melanie D Talson
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Juli Finlay
- Cumming School of Medicine, University of Calgary, AB, Canada
| | - Krista Rossum
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | | | | | - Arlene Desjarlais
- Can-SOLVE CKD Network Patient Council, Canada.,Can-SOLVE CKD Network Indigenous Peoples' Engagement and Research Council, Winnipeg, MB, Canada
| | | | - George Fontaine
- Can-SOLVE CKD Network Patient Council, Canada.,Can-SOLVE CKD Network Indigenous Peoples' Engagement and Research Council, Winnipeg, MB, Canada
| | - Rachelle Sass
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Matthew James
- Cumming School of Medicine, University of Calgary, AB, Canada
| | - Manish M Sood
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, ON, Canada
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - Neesh Pannu
- Department of Medicine, University of Alberta, Edmonton, Canada
| | | | | | | | - Clara Bohm
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.,Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada
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