The Perfect Storm: Stakeholder Perspectives on Factors Contributing to Hospital Admissions for Patients Undergoing Maintenance Hemodialysis

Nephrol Nurs J. 2020 Jan-Feb;47(1):11-20.

Abstract

Patients living with end stage renal disease (ESRD) who are undergoing hemodialysis experience frequent hospitalizations associated with complications of care and exacerbations of illness. Efforts to reduce hospitalizations have had limited success. The purpose of this study was to explore why hospitalizations occur from the perspectives of patients undergoing hemodialysis treatment, their caregivers, and health care providers. Semi-structured interviews and focus groups were conducted with 21 patients living with ESRD, 10 caregivers, and three focus groups with health care professionals. Findings are discussed under four main themes: Graft site/Catheter/Access issues, "My resistance is low," "I could not breathe,"" and "The perfect storm." Results highlight the complexity of care and vulnerability of patients with ESRD. Further interprofessional research is needed to improve transitional care and care delivery for patient populations receiving hemodialysis.

Keywords: dialysis; end stage renal disease; hemodialysis; hospitalization; kidney failure (chronic).

MeSH terms

  • Caregivers / psychology
  • Focus Groups
  • Hospitalization / statistics & numerical data*
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Renal Dialysis*
  • Risk Factors
  • Stakeholder Participation