Barriers to and facilitators of care for hemodialysis patients; a qualitative study

Abstract

Introduction: Patients undergoing hemodialysis require direct and continuous care. Identifying the barriers to and factors facilitating hemodialysis care can improve care quality. Objectives: The aim of this study was to assess the barriers and facilitators of care for hemodialysis patients. Patients and Methods: This study was conducted as a qualitative study and it utilized content analysis approach. The study was performed in hemodialysis ward of Kowsar hospital in Semnan, in 2014. We used purposive sampling method with maximum diversity. Semi-structured interviews with open questions were used to collect data from a total of 20 participants. Results: The main topic of health care challenges was divided into two main categories, including the facilitators and barriers of hemodialysis care. The facilitators of hemodialysis care had four subcategories, including "intimate relationship", "basic knowledge", "hemodialysis skills", and "experience". The category of barriers had eight subcategories, including "shortage of nurses and heavy workload", "weak authority of the head nurse", "ignorant director of nursing", "shortage of nephrologists", "lack of vascular surgery expert", "lack of nurse’s aide and nursing assistant ", "unskilled staffs", and "interference by patients’ caregivers". Conclusion: The findings of this study showed that access to human resources and their abilities were among the factors facilitating care. However, lack of qualified medical staff at each level of care delivery was one of the barriers to hemodialysis care. Hence, it is of great importance for policy makers, managers, and program designers to recruit human resources who have the characteristics and competencies required for providing hemodialysis care.

Carga laboral de las enfermeras en Unidades de Hemodiálisis Crónica según dependencia y riesgo de los pacientes

“…El cuidado de los pacientes sometidos a HDC requiere de un equipo multidisciplinario, nefrólogo, enfermera, nutricionista, entre otros 4 . En particular se requiere que la enfermera tenga habilidades interpersonales, competencias técnicas y clínicas para otorgar una atención segura y de calidad 5 . El personal de enfermería representa cerca del 45% de la fuerza de trabajo de una Unidad de Hemodiálisis (UHD), siendo parte de los costos directos de la diálisis 6,7 .…”

Hemodialysis Adequacy Sacrificed for Business: A Qualitative Study

“…Nobahar in a content analysis presented eight categories on the obstacles to hemodialysis care; one of them was "weak authority of the head nurse" (28). In the current study, poor supervision was one of the barriers to high -6…”

Hemodialysis Patient Care in Renal Dialysis Unit among Selected Hospitals in the Sultanate of Oman

“…The delivery of continuous and coordinated care lessens the demand for hospital services, waiting times for other services in different parts of the hospital, and the threat of complications [33][34]. That is why patients treated with hemodialysis not only have a low health related quality of life as [35] as well as eexperienced mortality rates of 15%-20% each year [36].…”

“…However, lack of qualified medical staff at each level of care delivery was one of the barriers to hemodialysis care. Hence, it is of great importance for policy makers, managers, and program designers to recruit human resources who have the characteristics and competencies required for providing hemodialysis care [22].…”