This study was done with the purpose of clarifying the concept of patient perceived quality of nursing care in hemodialysis. In this meta-synthesis study, qualitative studies was searched in the four interntional databases from January 1st, 2000 to December 30th, 2019. The keywords used were: nursing care quality, and hemodialysis. Studies which had been done with the purpose of understanding the patient perceived quality of nursing care concept aomg hemodialysis patients were included. Two researchers were evaluate the quality of included studies separately using JBI tool, required information were extracted using the designed table. The main themes in the structure dimension include Sufficient Human resource, quality of equipment, financial support from patient and quality of the patient care environment. Process dimension consisted of continuous monitoring of the syndromes, effective patient education, efficient care, effective therapeutic relationship, and patient’s empowerment and participation in the process, and in the outcome dimension included high dialysis adequecy, patient burnout reduction, and increased patient satisfaction from services. The results of the study indicated a comprehensive, deep and interactive dimensions about the concept of nursing quality of care.

Introduction: Dialysis adequacy is one of the most important indicators for measuring the quality of care provided in hemodialysis (HD) wards. Despite individual studies, there is still no comprehensive study about dialysis adequacy in the Eastern Mediterranean Region (EMRO). This study was conducted to evaluate the dialysis adequacy in HD patients in the EMRO. Methods: In the present systematic review and meta-analysis international (EMBASE, Scopus, PubMed, Web of Science) and national (SID, MAGIRAN) databases were searched for related articles using keywords “dialysis adequacy” and “EMRO” from 1 January 2000 to April 30, 2020. The quality of studies was studied using Hoy et al instrument. Results: Out of 966 retrieved studies, 63 studies conducted on 15462 HD patients were included. The pooled mean of KT/V and URR were 1.24 (95% CI: 1.19, 1.30) and 63.03% (95% CI: 61.31, 64.75), respectively. The pooled prevalence of Kt/V>1.2 and URR>65.0% were 42.73% (95% CI: 31.58, 53.88) and 42.52% (95% CI: 25.3, 59.7), respectively. Conclusion: The results of the present study indicate the poor dialysis adequacy in the EMRO region and the need to improve the physical infrastructure, workforce, and pieces of equipment in hemodialysis wards.