Home Hemodialysis

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Qualitative and Quantitative Articles on Home Hemodialysis
Elizabeth Hetherington
Northeastern University

Receiving hemodialysis in the in-patient or outpatient setting is uncomfortable and non-pleasurable. Thankfully, “the movement of medical care out of institutional settings into patients’ homes has increased in most industrialized countries as part of the general emergence of self- care options in the healthcare field” (Halifax, 2009, p. 27). In relation to this, an alternative option has become available for Dialysis patients called Nocturnal Home Hemodialysis (NHHD) within the past few years. This new method allows patients to complete treatments within their own homes privately. These patient’s self-administer hemodialysis “for 6 to 8 hours, 5 to 6 nights per week” (Halifax, 2009, p. 28). Not only is the patient’s life made somewhat easier, there may be an “impact on medical expenses in general, including the number of hospital admissions and the amount of prescription medications required” (Halifax, 2009, p. 28).

Two articles, one qualitative and one quantitative, both correlate to this new advance. The first, Patients’ Experiences with Learning A Complex Medical Device for the Self-Administration of Nocturnal Home Hemodialysis is a qualitative study, and the second, Hemodialysis patients’ perceptions of home hemodialysis and self-care, is a quantitative study. Both articles aimed to address and assess the patient’s perceptions and experiences involving NHHD.

In article 1, Patients’ Experiences with Learning A Complex Medical Device for the Self-Administration of Nocturnal Home Hemodialysis, the topic being reviewed explores “patients training experiences related to the self-administration of hemodialysis at home” (Halifax, 2009, p. 27). The researchers, Nancy V.D. Halifax, Jennifer Wong, Joan Eakin, Paul Migram, Joseph A. Cafazzo, and Christopher T. Chan, had three objectives when going into this study. The first was to, “explain how successful nocturnal home hemodialysis can improve patients’ and caregivers’ lives” (Halifax, 2009, p. 27). The second objective was to, “identify anxieties, concerns, and levels of understanding as expressed by participants in this qualitative study” (Halifax, 2009, p. 27). And lastly to, “describe how this study may serve to identify patient education as a domain when providers instruct patients on the use of technology required for their treatments” (Halifax, 2009, p. 27).

In article 2, Hemodialysis patients’ perceptions of home hemodialysis and self-care, the main focus is on assessing, “in-centre hemodialysis patients’ perceptions regarding home dialysis, as well as their self-care ability” (Visaya, 2010, p. 23). Marie Angela Visaya, the author, used the Theory of Planned Behavior to support whether or not someone would carry out home dialysis. She states that, “if a patient has a positive attitude regarding home dialysis and the patient’s friends and family members are encouraging of this behavior, then the patient will do home dialysis therapy” (Visaya, 2010, p. 24).

The sample used by Halifax involved 23 end stage renal disease (ESRD) patients and caregivers who were learning how to operate a hemodialysis machine and how to administer their own treatments at home without the supervision of a clinician. This sample was obtained at Toronto General Hospital’s Nocturnal Home Hemodialysis training program. The qualitative design used, “semi- structured interviews and a focus group to explore patients’ comparison and experiences of NHHD training” (Halifax, 2009, p. 28)....
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