Dataset Information

Clinician beliefs and attitudes about home haemodialysis: a multinational interview study.

ABSTRACT:

Objectives

To explore clinician beliefs and attitudes about home haemodialysis in global regions where the prevalence of home haemodialysis is low, and to identify barriers to developing home haemodialysis services and possible strategies to increase acceptance and uptake of home haemodialysis.

Design

Semistructured interviews, thematic analysis.

Setting

15 dialysis centres in Italy, Portugal, France, Germany, Sweden and Argentina.

Participants

28 nephrologists and 14 nurses caring for patients receiving in-centre haemodialysis.

Results

We identified four major themes as being central to clinician beliefs about home haemodialysis in regions without established services: external structural barriers (ready access to dialysis centres, inadequate housing conditions, unstable economic environment); dialysis centre characteristics (availability of alternative treatments, competing service priorities, commercial interests); clinician responsibility and motivation (preserving safety and security, lack of awareness, knowledge and experience, potential to offer lifestyle benefits, professional interest and advancement); and cultural apprehension (an unrelenting imposition, carer burden, attachment to professional healthcare provision, limited awareness).

Conclusions

Despite recognising the potential benefits of home haemodialysis, clinicians practicing in Europe and South America felt apprehensive and doubted the feasibility of home haemodialysis programmes. Programmes that provide clinicians with direct experience of home haemodialysis could increase acceptance and motivation for home-based haemodialysis, as might service prioritisation and funding models that favour home haemodialysis.

SUBMITTER: Tong A

PROVIDER: S-EPMC3533066 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Clinician beliefs and attitudes about home haemodialysis: a multinational interview study.

Tong Allison A Palmer Suetonia S Manns Braden B Craig Jonathan C JC Ruospo Marinella M Gargano Letizia L Johnson David W DW Hegbrant Jörgen J Olsson Måns M Fishbane Steven S Strippoli Giovanni F M GF

BMJ open 20121212 6

<h4>Objectives</h4>To explore clinician beliefs and attitudes about home haemodialysis in global regions where the prevalence of home haemodialysis is low, and to identify barriers to developing home haemodialysis services and possible strategies to increase acceptance and uptake of home haemodialysis.<h4>Design</h4>Semistructured interviews, thematic analysis.<h4>Setting</h4>15 dialysis centres in Italy, Portugal, France, Germany, Sweden and Argentina.<h4>Participants</h4>28 nephrologists and 1 ...[more]

PMID: 23242245

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Project description:Background: More than a decade after the National Institute for Health and Clinical Excellence recommendation of home haemodialysis (home HD) for 10-15% of those needing renal replacement therapy, the uptake across different regions in the UK remains uneven. Methods: This survey is part of the Barriers to Successful Implementation of Care in Home Haemodialysis (BASIC-HHD) study, an observational study of patient and organizational factor barriers and enablers of home HD uptake, in the UK. The study centres had variable prevalence of home HD by design [low: <3% (2), medium: 5-8% (2) and high: >8% (1)]. This survey was administered electronically in 2013, and had 20 questions pertaining to home HD beliefs and practices. A total of 104 members of staff across five study centres were approached to complete the survey. Results: The response rate was 46%, mostly from experienced HD practitioners. Most believed in the benefits of home HD therapy. Across all centres, respondents believed that preconceptions about patients' and carers' ability to cope with home HD (35% to a great or very great extent) and staff knowledge and bias influenced offer of home HD therapy (45%). Also, compared with respondents from high prevalence (HP) centre, those from low prevalence (LP) centres felt that display and presentation of dialysis information lacked clarity and uniformity (44% versus 18%), and that a better set-up for training patients for self-care HD was required (72.8% versus 33.3%). A greater proportion of respondents from the HP centre expressed concerns over caregiver support and respite care for patients on home HD (63.7% versus 33.3%). Conclusions: Survey results indicate that across all centres in the study, there is an appetite for growing home HD. There are some differences in attitudes and practice between LP and HP centres. There are other domains where all centres have expressed concern and addressing these will be influential in navigating change from the current course.

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Dataset Information

Clinician beliefs and attitudes about home haemodialysis: a multinational interview study.

Objectives

Design

Setting

Participants

Results

Conclusions

Publications

Clinician beliefs and attitudes about home haemodialysis: a multinational interview study.

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