It’s not quite as I expected. Perspectives on the experience of home haemodialysis.

Abstract

Background: The UK target of providing home haemodialysis (HHD) to 10-15% of the dialysis cohort is not being met. This qualitative study explored experiences of home and in-centre haemodialysis (ICHD) to provide perspectives on barriers to uptake and maintenance of HHD. Methods: Semi-structured interviews with 32 patients receiving HHD (n=18) or ICHD (n=14) were analysed using framework analysis. The two groups were analysed in turn, then both data sets were considered together. This novel technique compared the lived experience (of HHD patients) with the anticipated one (of ICHD patients). Results: An over-arching theme was the discrepancy between the anticipated experience of HHD and the lived experience for patients who took up the modality. Sub themes were: altered perception of the self on dialysis; one-size-does-not-fit-all; HHD involves compromise; and the impact of HHD on family and friends. Conclusion:  An educational intervention, possibly delivered by expert patients, would provide information on elements of HHD which potential patients may not yet have considered. This would empower patients to make informed decisions about which modality would suit them best.