How an ordeal becomes the norm: A qualitative exploration of experiences of self‐cannulation in male home haemodialysis patients

Moore, Currie; Majeed‐Ariss, Rabiya; Jayanti, Anuradha; Mitra, Sandip; Skevington, Suzanne M.; Wearden, Alison

doi:10.1111/bjhp.12303

Cited by 7 publications

(10 citation statements)

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“…Only four studies were directly about cannulation. 8,9,17,18 Other studies were about pain, 26,27 experiences of VA for haemodialysis, 14,[28][29][30][31][32][33] experiences of in-centre and home haemodialysis [34][35][36][37][38][39][40][41][42][43][44][45][46] and research priority setting. 47 Studies were conducted across five continents, but despite this diversity in study location themes extracted did not seem to vary due to culture, with the exception of one study, which developed themes linked to religion in a Thai culture.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies included in our review specifically explored home haemodialysis, [42][43][44][45][46] generating themes around self-cannulation, with two further studies exploring self-cannulation. 17,33 Whilst it is tempting to believe that self-cannulation will improve cannulation experience for many patients and should be promoted, our review indicates that self-cannulation is also difficult to achieve. It is unlikely to be a viable solution for all haemodialysis patients.…”

Section: Discussionmentioning

confidence: 97%

“…The necessity and regularity of the procedure creates the need to survive this procedure, regardless of how unpleasant this is. 9,14,17,18,27,29,30,31,32,33,34,36,37,38,40,41,42,43,45,46 High confidence -…”

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confidence: 99%

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Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

et al. 2022

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Introduction: Cannulation is an essential part of haemodialysis with arteriovenous access. Patients’ experiences of cannulation for haemodialysis are problematic but poorly understood. This review aims to synthesise findings related to patients’ experiences of cannulation for haemodialysis from qualitative studies, providing a fuller description of this phenomenon. Methods: Eligibility criteria defined the inclusion of studies with a population of patients with end-stage kidney disease on haemodialysis. The phenomena of interest was findings related to patients’ experiences of cannulation for haemodialysis and the context was both in-centre and home haemodialysis. MedLine, CINAHL, EMBASE, EMCARE, BNI, PsycInfo and PubMed were last searched between 20/05/2019 and 23/05/2019. The quality of studies was assessed using the using Joanna Briggs Critical Appraisal Checklist for Qualitative Research. Meta-aggregation was used to synthesise findings and CERQual to assess the strength of accumulated findings. Results: This review included 26 studies. The subject of included studies covered cannulation, pain, experiences of vascular access, experiences of haemodialysis and a research priority setting exercise. From these studies, three themes were meta-aggregated: (1) Cannulation for haemodialysis is an unpleasant, abnormal and unique procedure associated with pain, abnormal appearance, vulnerability and dependency. (2) The necessity of cannulation for haemodialysis emphasises the unpleasantness of the procedure. Success had multiple meanings for patients and patients worry about whether the needle insertion will be successful. (3) Patients survive unpleasant, necessary and repetitive cannulation by learning to tolerate cannulation and exerting control over the procedure. Feeling safe can help them tolerate cannulation better and the cannulator can invoke feeling safe. However, some patients still avoid cannulation, due to its unpleasantness. Conclusions: Cannulation is a pervasive procedure that impacts on patients’ experiences of haemodialysis. This review illuminates further patients’ experiences of cannulation for haemodialysis, indicating how improvements can be made to cannulation. Registration: PROSPERO (CRD42019134583).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

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Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

et al. 2022

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“… 5 HD is currently the primary treatment used for ESRD patients. 6 Maintenance haemodialysis (MHD) requires the patient to receive regular in-hospital haemodialysis lasting 4–5 hours 2–3 times per week. More than 90% of ESRD patients in China are treated with MHD, with an annual rate of increase of 20%.…”

Section: Introductionmentioning

confidence: 99%

“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Xie¹,

Li²,

Li³

2023

RMHP

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Background Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH. Methods We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi’s phenomenological approach. Results Twenty-two respondents completed the interviews (aged 29–75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends’ helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison). Conclusion The study reveals that multiple stressors drive MHD patients’ LH. These salient phenomena demonstrate the importance of recognizing MHD patients’ LH. We suggest that support services should be developed alongside a framework that addresses MHD patients’ LH from the beginning of treatment.

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“…It recognizes that our experiences are perceived and interpreted at an individual level [ 15 ], hence we felt it was an appropriate methodological approach for this study. IPA has been widely used within health care research to explore the experience of illness by patients and caregivers [ 16 , 17 ]. With increased emphasis on patient-reported experience measures and their recognized correlation with patient-reported outcomes [ 18 ], this methodological approach may gain further in popularity.…”

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confidence: 99%

Why do people choose nephrology? Identifying positive motivators to aid recruitment and retention

Beckwith

Kingsbury

Horsburgh

2018

Clinical Kidney Journal

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Increasing concerns about recruitment and retention of junior doctors have led to renewed interest in how and when trainees choose their specialties. To our knowledge, no study has yet reported what attracts UK applicants to nephrology nor how clinicians develop vocational interests or make occupational choices. With this in mind, we sought to explore the motivation behind current nephrologist’s career choices in the UK. We interviewed 11 nephrologists using a semi-structured face-to-face approach and used interpretative phenomenological analysis to conduct and analyse the interviews. We found role models were pivotal in encouraging specialization in nephrology, particularly those encountered in early postgraduate training. The diversity, diagnostic challenge and cross-specialty knowledge was highlighted as well as the ability to ‘make a difference to patients’ lives’. Nephrologists enjoyed the challenge of managing very sick, acutely unwell patients as well as the holistic continuity of long-term care offered to dialysis patients and their families. Academic and procedural components were attractive motivators to the specialty and the flexibility to have multiple interests was noted, with many nephrologists having ‘portfolio’ careers. Based on these results, we suggest strategies the specialty can use to aid policy decision making, promote recruitment and improve educational experiences within current training programmes.

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How an ordeal becomes the norm: A qualitative exploration of experiences of self‐cannulation in male home haemodialysis patients

Cited by 7 publications

References 32 publications

Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Why do people choose nephrology? Identifying positive motivators to aid recruitment and retention

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