The Impact of Falls: A Qualitative Study of the Experiences of People Receiving Haemodialysis

Abstract

The prevalence of falls is high in people receiving haemodialysis (HD). This study aimed to explore the experiences of people receiving HD who had fallen in the last six months. A qualitative study, informed by constructivist grounded theory, used semi-structured interviews in combination with falls diaries. Twenty-five adults (mean age of 69 ± 10 years, 13 female, 13 White British) receiving HD with a history of at least one fall in the last six months (median 3, IQR 2–4) participated. Data were organised within three themes: (a) participants’ perceptions of the cause of their fall(s): poor balance, weakness, and dizziness, exacerbated by environmental causes, (b) the consequences of the fall: injuries were disproportionate to the severity of the fall leading to loss of confidence, function and disruptions to HD, (c) reporting and coping with falls: most did not receive any specific care regarding falls. Those who attended falls services reported access barriers. In response, personal coping strategies included avoidance, vigilance, and resignation. These findings indicate that a greater focus on proactively identifying falls, comprehensive assessment, and timely access to appropriate falls prevention programmes is required to improve care and outcomes.

Frailty in hemodialysis patients: results of a screening program and multidisciplinary interventions

“…Recent studies have concluded that focus on the identification of patients at risk, comprehensive assessment, and the implementation of prevention programs are required to reduce falls [ 41 ]. A global incidence of 0.85–1.60 falls per patient/year in hemodialysis patients has been reported [ 42 ].…”