Hemodialysis Adequacy Sacrificed for Business: A Qualitative Study

Dialysis adequacy is a predictor for mortality and morbidity in patients undergoing hemodialysis. Previous studies pinpointed several factors as barriers to adequate dialysis. However, there is a scarcity of studies investigating the experiences of patients undergoing hemodialysis and health care providers (e g, dialysis nurses and nephrologists) with regards to high-quality dialysis barriers. The current study aimed at gaining a deeper understanding regarding the experiences of patients undergoing hemodialysis and dialysis professionals about the subjective barriers to hemodialysis adequacy.
The current study was conducted using the conventional content analysis method; 19 patients undergoing hemodialysis, 2 hemodialysis caregivers, 2 hemodialysis nurses, and 2 nephrologists were included and interviewed.
Based on the obtained data, 993 initial codes were extracted under four categories: barrier of self, social support insufficiency, hemodialysis mafia, and supervision weakness.
Patients undergoing hemodialysis and health care providers have different experiences compared with what is mentioned in textbooks about barriers to high-quality dialysis. The findings highlight the need for immediate re-examination and preparation of the standards for the quality of hemodialysis, as well as attention and focus on non-physiological barriers to dialysis adequacy.