Urbanski Megan, Blythe Emma, Hamblin Alicia, Bender Alexis A, Hoge Courtney, Douglas-Ajayi Clarica, Rickenbach Fran, Joseph Jessica, Damron Kelli Collins, Morgan Jennifer Craft, Jaar Bernard, Plantinga Laura
Division of Transplant, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
Health Services Research Center, Emory University, Atlanta, GA.
Kidney Med. 2024 Nov 14;7(1):100934. doi: 10.1016/j.xkme.2024.100934. eCollection 2025 Jan.
RATIONALE & OBJECTIVE: Dialysis patient care technicians (PCTs) provide essential, frontline care for patients receiving in-center hemodialysis. We qualitatively explored perceptions of the PCT job role, responsibilities, and training among current PCTs, non-PCT dialysis staff, and patients receiving hemodialysis.
Focus group study.
SETTING & PARTICIPANTS: Discussions were conducted in March-May 2023 among US PCTs, non-PCT staff, and patients.
Thematic analysis was conducted using inductive and deductive strategies.
Seven focus groups (N = 36 participants) were conducted (3 with PCTs [n = 19], 2 with non-PCT staff [n = 6], and 2 with patients [n = 11]). Eight themes emerged: (1) value of PCT role is not reflected in job or organizational policies and structures; (2) PCTs play a flexible and often ill-defined role in dialysis clinics; (3) despite being in a position with high risk of burnout, PCTs find ways to persevere and provide high-quality care; (4) PCTs are often perceived as "helpers" or ancillary rather than an integral part of the dialysis care team; (5) PCT job training and qualifications are not standardized and often not commensurate with job expectations and responsibilities; (6) PCT-patient relationships are deeply valued, but boundaries can be fluid and become blurred because of the frequency and nature of dialysis care; (7) dialysis patients and staff are vulnerable to multilevel workplace safety issues; and (8) PCT-staff dynamics have a strong impact on employee morale, clinic efficiency, and patient satisfaction.
Non-English-speaking participants and physicians were excluded, limiting diversity in perspectives.
PCTs play a multifaceted role in dialysis care that is highly valued among patients and staff but not always reflected in actual tasks performed by PCTs, training received by PCTs, or the respect afforded to PCTs. Our findings are actionable and can inform future intervention-based work aimed at improving the PCT role in US hemodialysis care.
透析患者护理技术员（PCTs）为接受中心血液透析的患者提供至关重要的一线护理。我们对当前的PCTs、非PCT透析工作人员以及接受血液透析的患者对PCT工作角色、职责和培训的看法进行了定性探索。
焦点小组研究。
2023年3月至5月在美国的PCTs、非PCT工作人员和患者中进行了讨论。
采用归纳和演绎策略进行主题分析。
进行了7个焦点小组讨论（N = 36名参与者）（3个小组由PCTs组成[n = 19]，2个小组由非PCT工作人员组成[n = 6]，2个小组由患者组成[n = 11]）。出现了8个主题：（1）PCT角色的价值在工作或组织政策及结构中未得到体现；（2）PCTs在透析诊所中扮演着灵活且通常定义不明确的角色；（3）尽管处于职业倦怠风险较高的岗位，但PCTs仍找到坚持下去并提供高质量护理的方法；（4）PCTs常被视为“助手”或辅助人员，而非透析护理团队的组成部分；（5）PCT工作培训和资质不规范，且往往与工作期望和职责不匹配；（6）PCT与患者的关系深受重视，但由于透析护理的频率和性质，界限可能不固定且变得模糊；（7）透析患者和工作人员容易受到多层次工作场所安全问题的影响；（8）PCT与工作人员的动态关系对员工士气、诊所效率和患者满意度有很大影响。
排除了非英语参与者和医生，限制了观点的多样性。
PCTs在透析护理中扮演多方面角色，患者和工作人员对其高度重视，但这在PCTs实际执行的任务、接受的培训或获得的尊重中并不总是得到体现。我们的研究结果具有可操作性，可为未来旨在改善PCTs在美国血液透析护理中角色的基于干预的工作提供参考。
