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Abstract: SA-PO296

Starting Hemodialysis: A Qualitative Study of Patients' Experiences and Perspectives

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Mehta, Kshama R., Satellite Healthcare, San Jose, California, United States
  • Leuther, Kerstin, Satellite Healthcare, San Jose, California, United States
  • Fegler, Alexandra L., Satellite Healthcare, San Jose, California, United States
  • Schiller, Brigitte, Satellite Healthcare, San Jose, California, United States
  • Bennett, Paul N., Satellite Healthcare, San Jose, California, United States
  • Hussein, Wael F., Satellite Healthcare, San Jose, California, United States

Group or Team Name

  • Satellite Health Care

People commencing dialysis experience anxiety, depression and hospitalizations. Limited qualitative data is available to describe the experience and perspectives of people starting dialysis.


Adult English speaking patients within 90 days of starting in-center hemodialysis (HD) at centers of a nonprofit dialysis provider in Northern California were invited to join the study using a convenience based sampling method until theme saturation was reached. Audio-recorded, individual, semi-structured interviews conducted by trained qualitative researchers were de-identified and transcribed verbatim before being inductively coded into Level 1 codes, Level 2 categories, and Level 3 themes.


Three overarching themes emerged from twenty participants (55% male, 45% Caucasian, mean age 63, 66% with some college education, median HD vintage of 2 months). Theme 1, Being overwhelmed when starting dialysis, realizes the emotional unpreparedness of patients starting dialysis, dialysis side effects, the all-encompassing lifestyle changes and how trust and confidence in the dialysis center staff decreases anxiety to enable a positive dialysis start experience. Theme 2, Making sense of it all (for better or for worse), covers how impressions of the dialysis environment (waiting and treatment areas) and building a community with other patients/staff contributes to a positive start. Theme 3, Moving forward, describes how the right education at the right time supports optimal informed decision-making and positions patients for success by increasing hope for a longer and better life.


Understanding the life-changing experience that patients encounter when starting dialysis can benefit hemodialysis clinicians in individualizing patient care to help patients adjust and develop long-term coping strategies. Improved patient experience is realized by : improving the center’s physical environment, developing peer support programs, providing lifestyle support, implementing more person-centered care models, offering learning style-tailored education, providing care focused on individual patient goals, and enabling shared decision-making.


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