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Kidney Week

Abstract: TH-PO233

Travel Arrangements in In-Center Hemodialysis: A Qualitative Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wongboonsin, Janewit, University of Minnesota, Minneapolis, Minnesota, United States
  • Merighi, Joseph R., University of Minnesota, Minneapolis, Minnesota, United States
  • Drawz, Paul E., University of Minnesota, Minneapolis, Minnesota, United States
Background

For people with end-stage renal disease, “travel” and “independence” are rated as 2 of the top 5 factors that inform their treatment modality choice. The limits imposed by in-center hemodialysis (IHD) treatment can present a variety of challenges for patients who wish to travel. This exploratory study investigated how IHD patients managed their travel and the role of dialysis social workers in executing travel arrangements for patients.

Methods

An interview-based, qualitative study was conducted with IHD patients being treated at a University-affiliated hospital and community-based dialysis social workers. Patients were screened from an inpatient nephrology consult panel and, after enrolling in the study, provided contact information for their dialysis social workers. Two coders used a grounded theory (constant comparative) approach to analyze the data from verbatim transcriptions.

Results

Sixteen patients and eight social workers were enrolled in the study. The patient sample included 8 women (50%), 13 whites (81.3%), and a mean dialysis vintage of 5 years. The social worker were all women and had a mean of 6 years of practice experience. Three overarching themes emerged from the interviews: the process, barriers, and facilitators of travel. The travel process subthemes included communication, dialysis schedule, and travel itinerary. The barrier and facilitator subthemes were categorized into patient, dialysis unit, and supporting factors. These subthemes addressed caregiver roles, being flexible, staff professionalism, and managing unanticipated situations. Overall, there was lack of uniform infrastructure and understanding regarding the travel process at the patient level, provider level, and system level.

Conclusion

This study identified multiple perspectives surrounding travel arrangements in chronic IHD patients. There is limited research on travel issues for chronic IHD patients and this investigation is among the first to articulate barriers and facilitators associated with travel from the perspective of patients and social workers. Promoting and supporting travel for IHD patients can serve to increase their sense of autonomy and provide opportunities to improve their quality of life.