Kidney Dialysis Service: Experiences of Consumer and Provider and Quality of Life of End Stage Kidney Disease Patients in Parbat, Nepal

Abstract

Background/Objectives: The kidney dialysis patients and service providers possess a wide range of experience relating to the service and quality of life is an important measure to evaluate holistic approach to chronic disease management such as kidney disease. This study was conducted to find out the experience of kidney dialysis patients and service providers and quality of life of end stage kidney disease patients. Methods: A qualitative study was conducted, from March 2024 to August 2024, among 20 end stage kidney disease patients visiting Parbat hospital for dialysis and 7 dialysis service providers, doctor and nurses, using in-depth interview guidelines, kidney disease quality of life-36 instrument (for end stage kidney disease patients) and job satisfaction survey tool (for service providers). Thematic analysis was performed from the transcribed and translated recorded information to carry out the actual theme. Result: Nine (9) themes were extracted for experiences of kidney dialysis patients. They were (i) perception on end-stage kidney disease, (ii) perception on free kidney dialysis service at the hospital, (iii) administrative process for free dialysis service, (iv) feasibility with the schedules of dialysis session, (v) quality of care and response of service providers (vi) duration of dialysis session (vii) desires and challenges towards kidney transplantation, (viii) on recommending the dialysis site and (ix) further expectations for improvement. The quality of life of end-stage kidney disease patients was found to be moderate. Similarly, nine (9) themes were extracted for experiences of service providers. They were (i) patient personalized care and understanding patients' behavior (ii) addressing queries and concerns of the patients (iii) rewarding aspect of the job (iv) learning acceptance and witnessing positivity (v) availability of safety measures and protective protocols (vi) training and professional development experience (vii) reflection on job security (viii) challenging aspect of the job (ix) further expectations and requests. The kidney dialysis service providers were found to be ambivalent, neither satisfied nor dissatisfied with the job. Conclusion: Patients share an overall good experience of free kidney dialysis service at Parbat hospital while the service providers also have a positive experience working in the dialysis section. However, expectations for provision of free medications and availability of nephrologist by the end stage kidney disease patients direct towards the reforms for improved service delivery. The doctor and nurses should be provided with more opportunities for professional development and safety should be a priority. These respective vigilance and actions for, shall address the quality of life and job satisfaction as well.