Patient satisfaction with in-centre haemodialysis care: an international survey

Abstract

ObjectivesTo evaluate patient experiences of specific aspects of haemodialysis care across several countries.DesignCross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire.SettingHaemodialysis clinics within a single provider in Europe and South America.Participants2748 adults treated in haemodialysis.Primary and secondary outcomesThe primary outcome was patient satisfaction with overall care. Secondary outcomes included patient experiences of individual aspects of dialysis care.Results2145 (78.1%) adults responded to the questionnaire. Fewer than half (46.5% (95% CI 44.5% to 48.6%)) rated their overall care as excellent. Global perceptions of care were uninfluenced by most respondent characteristics except age and depressive symptoms; older respondents were less critical of their care (adjusted OR for excellent rating 1.44 (1.01 to 2.04)) and those with depressive symptoms were less satisfied (0.56 (0.44 to 0.71)). Aspects of care that respondents most frequently ranked as excellent were staff attention to dialysis vascular access (54% (52% to 56%)); caring of nurses (53% (51% to 55%)); staff responsiveness to pain or discomfort (51% (49% to 53%)); caring, helpfulness and sensitivity of dialysis staff (50% (48% to 52%)); and ease of reaching dialysis staff by telephone (48% (46% to 50%)). The aspects of care least frequently ranked as excellent were information provided when choosing a dialysis modality (23% (21% to 25%)), ease of seeing a social worker (28% (24% to 32%)), information provided about dialysis (34% (32% to 36%)), accuracy of information from nephrologist (eg, about prognosis or likelihood of a kidney transplant; 37% (35% to 39%)) and accuracy of nephrologists’ instructions (39% (36% to 41%)).ConclusionsHaemodialysis patients are least satisfied with the complex aspects of care. Patients’ expectations for accurate information, prognosis, the likelihood of kidney transplantation and their options when choosing dialysis treatment need to be considered when planning healthcare research and practices.

A Thematic Synthesis of the Experiences of Adults Living with Hemodialysis

“…This requires professionals to be aware of the need for many patients to foster relationships that enable ongoing information provision, communication, and support. A perceived lack of information sharing has been linked with reduced satisfaction with care (7,52,53). In common with other studies, this synthesis highlights problems with information sharing between health professionals and patients with CKD (6,7,52,54).…”

“…Although there has been some reported improvement in survival in recent years (2,4), studies have shown no improvement in quality of life (3). Deficiencies in satisfaction with hemodialysis care have also been shown (5)(6)(7). Satisfaction with care is unrelated to many of the clinical outcomes prioritized by physicians, and there is increasing evidence that outcomes commonly used in research and measured by registries may not be of importance to patients (6)(7)(8)(9).…”

“…Deficiencies in satisfaction with hemodialysis care have also been shown (5)(6)(7). Satisfaction with care is unrelated to many of the clinical outcomes prioritized by physicians, and there is increasing evidence that outcomes commonly used in research and measured by registries may not be of importance to patients (6)(7)(8)(9). There is growing interest in measuring outcomes that are of interest to patients through patient-reported outcome and experience measures.…”

Reason analysis for the causes of chronic kidney disease cases admitted in dialysis unit, satisfaction and their awareness and practices about restrictions in their dietary intake

“…16 Patients expressed positive response about good social interaction (88%) and staff interaction (99% 24 Suetonia C Palmer et al observed that as respondents the most frequently ranked and excellent was staff attention to dialysis vascular access (52% to 56%). 25 In our study, maximum (75%) numbers of patients were aware that Gua can be consumed, and then 59% were having knowledge about intake of pulses. None of them aware about almond, salted butter, Chinese salt meat, yeast products, tomato, soya sauce and cakes as a nonconsumable food items.…”

American Society of Nephrology Quiz and Questionnaire 2015: ESRD/RRT

“…However, we do not typically provide "excellent education to inform modality decision making." In a large survey of .2000 patients, ,25% of patients indicated that heath care providers gave "excellent" information when choosing HD or PD (6). Other large studies also found that a significant proportion of patients (approximately 40%-65%) felt that they did not have a choice in dialysis modality or that they were not informed of their choices (7,8) (choice A is incorrect).…”