How an ordeal becomes the norm: home haemodialysis patients’ experiences of self-cannulation

Abstract

Background: Despite home haemodialysis (HHD) being associated with significant health and psychosocial benefits, it remains an under-utilised form of renal replacement therapy for people with chronic kidney disease. Recent research suggests that self-cannulation is a barrier for patients, but there is little research which examines patients’ experience of self-cannulation or the role it plays in decision-making about dialysis modality. This qualitative study, a sub-study of the BASIC-HHD study, addressed these questions. Methods: Semi-structured interviews were conducted with 8 male HHD patients (duration on HHD ranged from 12-55 months). During the interview, the researcher elicited the participants’ lived experience of self-cannulation. Topics included the decision to self-cannulate and the impact of self-cannulation on the patient. The data collected were analysed using interpretative phenomenological analysis. Findings: A central theme was discussed throughout the interviews: “self-cannulation as a processâ€. Self-cannulation often begins as an ordeal but ends up becoming the norm. This theme was discussed in relation to four superordinate themes: “motivationâ€, “confidenceâ€, “acceptance†and “identityâ€. Discussion: The findings from this study suggest that initial fears of self-cannulation can be overcome. These findings offer healthcare professionals and patients alike a detailed view of how these particular patients who self-cannulate conceptualised it and its role in their mental and physical health. It also provides valuable insight as how to approach and overcome the barrier self-cannulation represents to some patients.