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Patients' experiences of transitioning between different renal replacement therapy modalities: A qualitative study.

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Abstract
BACKGROUND: Different kidney replacement therapy modalities are available to manage end-stage kidney disease, such as home-based dialysis, in-center hemodialysis, and kidney transplantation. Although transitioning between modalities is common, data on how patients experience these transitions are scarce. This study explores patients' perspectives of transitioning from a home-based to an in-center modality. METHODS: Patients transitioning from peritoneal dialysis to in-center hemodialysis were purposively selected. Semi-structured interviews were performed, digitally recorded, and transcribed verbatim. Data analysis, consistent with Charmaz' constructivist approach of grounded theory was performed. RESULTS: Fifteen patients (10 males; mean age 62 years) participated. The conditions of the transitioning process impacted the participants' experiences, resulting in divergent experiences and associated emotions. Some participants experienced a loss of control due to the therapy-related changes. Some felt tied down and having lost independence, whereas others stated they regained control as they felt relieved from responsibility. This paradox of control was related to the patient having or not having (1) experienced a fit of hemodialysis with their personal lifestyle, (2) a frame of reference, (3) higher care requirements, (4) insight into the underlying reasons for transitioning, and (5) trust in the healthcare providers. CONCLUSIONS: Care teams need to offer opportunities to elicit patients' knowledge and fears, dispel myths, forge connections with other patients, and visit the dialysis unit before transition to alleviate anxiety. Interventions that facilitate a sense of control should be grounded in the meaning that the disorder has for the person and how it impacts their sense of self.
Keywords
Decision-making, dialysis, experiences, home-based therapy, in-center modality, patient, process

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Please use this url to cite or link to this publication:

MLA
Holvoet, Els, et al. “Patients’ Experiences of Transitioning between Different Renal Replacement Therapy Modalities: A Qualitative Study.” Peritoneal Dialysis International, vol. Jan 13, 2020.
APA
Holvoet, E., Verhaeghe, S., Davies, S., Combes, G., François, K., Johnson, D., … Van Humbeeck, L. (2020). Patients’ experiences of transitioning between different renal replacement therapy modalities: A qualitative study. Peritoneal Dialysis International, Jan 13.
Chicago author-date
Holvoet, Els, S Verhaeghe, S Davies, G Combes, K François, D Johnson, Wim Van Biesen, and Liesbeth Van Humbeeck. 2020. “Patients’ Experiences of Transitioning between Different Renal Replacement Therapy Modalities: A Qualitative Study.” Peritoneal Dialysis International Jan 13.
Chicago author-date (all authors)
Holvoet, Els, S Verhaeghe, S Davies, G Combes, K François, D Johnson, Wim Van Biesen, and Liesbeth Van Humbeeck. 2020. “Patients’ Experiences of Transitioning between Different Renal Replacement Therapy Modalities: A Qualitative Study.” Peritoneal Dialysis International Jan 13.
Vancouver
1.
Holvoet E, Verhaeghe S, Davies S, Combes G, François K, Johnson D, et al. Patients’ experiences of transitioning between different renal replacement therapy modalities: A qualitative study. Peritoneal Dialysis International. 2020;Jan 13.
IEEE
[1]
E. Holvoet et al., “Patients’ experiences of transitioning between different renal replacement therapy modalities: A qualitative study.,” Peritoneal Dialysis International, vol. Jan 13, 2020.
@article{8656245,
  abstract     = {BACKGROUND:
Different kidney replacement therapy modalities are available to manage end-stage kidney disease, such as home-based dialysis, in-center hemodialysis, and kidney transplantation. Although transitioning between modalities is common, data on how patients experience these transitions are scarce. This study explores patients' perspectives of transitioning from a home-based to an in-center modality.

METHODS:
Patients transitioning from peritoneal dialysis to in-center hemodialysis were purposively selected. Semi-structured interviews were performed, digitally recorded, and transcribed verbatim. Data analysis, consistent with Charmaz' constructivist approach of grounded theory was performed.

RESULTS:
Fifteen patients (10 males; mean age 62 years) participated. The conditions of the transitioning process impacted the participants' experiences, resulting in divergent experiences and associated emotions. Some participants experienced a loss of control due to the therapy-related changes. Some felt tied down and having lost independence, whereas others stated they regained control as they felt relieved from responsibility. This paradox of control was related to the patient having or not having (1) experienced a fit of hemodialysis with their personal lifestyle, (2) a frame of reference, (3) higher care requirements, (4) insight into the underlying reasons for transitioning, and (5) trust in the healthcare providers.

CONCLUSIONS:
Care teams need to offer opportunities to elicit patients' knowledge and fears, dispel myths, forge connections with other patients, and visit the dialysis unit before transition to alleviate anxiety. Interventions that facilitate a sense of control should be grounded in the meaning that the disorder has for the person and how it impacts their sense of self.},
  author       = {Holvoet, Els and Verhaeghe, S and Davies, S and Combes, G and François, K and Johnson, D and Van Biesen, Wim and Van Humbeeck, Liesbeth},
  journal      = {Peritoneal Dialysis International},
  keywords     = {Decision-making,dialysis,experiences,home-based therapy,in-center modality,patient,process},
  language     = {und},
  title        = {Patients' experiences of transitioning between different renal replacement therapy modalities: A qualitative study.},
  url          = {http://dx.doi.org/10.1177/0896860819896219},
  volume       = {Jan 13},
  year         = {2020},
}

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