The beliefs and expectations of patients and caregivers about home haemodialysis: an interview study

Tong, Allison, Palmer, Suetonia, Manns, Braden, Craig, Jonathan C., Ruospo, Marinella, Gargano, Letizia, Johnson, David W., Hegbrant, Jorgen, Olsson, Mans, Fishbane, Steven and Strippoli, Giovanni F. M. (2013) The beliefs and expectations of patients and caregivers about home haemodialysis: an interview study. BMJ Open, 3 1: e002148.1-e002148.13. doi:10.1136/bmjopen-2012-002148

Author Tong, Allison
Palmer, Suetonia
Manns, Braden
Craig, Jonathan C.
Ruospo, Marinella
Gargano, Letizia
Johnson, David W.
Hegbrant, Jorgen
Olsson, Mans
Fishbane, Steven
Strippoli, Giovanni F. M.
Title The beliefs and expectations of patients and caregivers about home haemodialysis: an interview study
Journal name BMJ Open   Check publisher's open access policy
ISSN 2044-6055
Publication date 2013-01
Sub-type Article (original research)
DOI 10.1136/bmjopen-2012-002148
Open Access Status DOI
Volume 3
Issue 1
Start page e002148.1
End page e002148.13
Total pages 13
Place of publication London, United Kingdom
Publisher B M J
Collection year 2014
Language eng
Formatted abstract
Objectives: To explore the beliefs and expectations of patients and their caregivers about home haemodialysis in Italy where the prevalence of home haemodialysis is low.

Design: Semistructured, qualitative interview study with purposive sampling and thematic analysis.

Setting: Four dialysis centres in Italy without home haemodialysis services (Bari, Marsala, Nissoria and Taranto).

Participants: 22 patients receiving in-centre haemodialysis and 20 of their identified caregivers.

Results: We identified seven major themes that were central to patient and caregiver perceptions of home haemodialysis in regions without established services. Three positive themes were: flexibility and freedom (increased autonomy, minimised wasted time, liberation from strict dialysis schedules and gaining self-worth); comfort in familiar surroundings (family presence and support, avoiding the need for dialysis in hospital) and altruistic motivation to do home haemodialysis as an exemplar for other patients and families. Four negative themes were: disrupting sense of normality; family burden (an onerous responsibility, caregiver uncertainty and panic and visually confronting); housing constraints; healthcare by 'professionals' not 'amateurs' (relinquishing security and satisfaction with in-centre services) and isolation from peer support.

Conclusions: Patients without direct experience or previous education about home haemodialysis and their caregivers recognise the autonomy of home haemodialysis but are very concerned about the potential burden and personal sacrifice home haemodialysis will impose on caregivers and feel apprehensive about accepting the medical responsibilities of dialysis. To promote acceptance and uptake of home haemodialysis among patients and caregivers who have no experience of home dialysis, effective strategies are needed that provide information about home haemodialysis to patients and their caregivers, assure access to caregiver respite, provide continuous availability of medical and technical advice and facilitate peer patient support.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number e002148

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 15 times in Scopus Article | Citations
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