Patients' experiences of initiating unplanned haemodialysis

Abstract

BACKGROUND: Many patients with end stage kidney disease initiate dialysis in an unplanned fashion and as a result experience increased morbidity, mortality and make greater demands on health care resources. To deliver care appropriate to the needs of these patients it is imperative to gain insight into the perspective of each individual. AIM: To describe the meaning of the phenomenon "initiating haemodialysis in an unplanned fashion" experienced by the participants. DESIGN: The study used a lifeworld perspective with a descriptive phenomenological approach. PARTICIPANTS: Five patients (M 4, F 1), with experiences of the phenomenon were recruited from two dialysis units in southern Sweden. APPROACH: Individual in-depth interviews were undertaken, recorded and transcribed. The texts were analysed according to Giorgi's (2009) method. FINDINGS: The essence of the phenomenon was described as a life situation characterised by a rapid decline in health and kidney function leading to unplanned initiation of haemodialysis, which resulted in not really being able to understand what had happened. The sudden initiation of haemodialysis affected each patient in various ways and gave rise to thoughts of life's meaning. Support from others, acceptance and inner strength were helpful. Patients wished for more in-depth conversations with health care professionals. CONCLUSION: Psychological support is critical. Health care professionals need to have the time and the necessary skills in communication and empathetic listening to understand the psychological trauma each patient goes through in the unplanned setting.