Talson Melanie D, Ferreira da Silva Priscila, Finlay Juli, Rossum Krista, Soroka Kaytlynn V, McCormick Michael, Desjarlais Arlene, Vorster Hans, Sass Rachelle, James Matthew, Sood Manish M, Jaure Allison, Pannu Neesh, Tennankore Karthik, Thompson Stephanie, Tonelli Marcello, Bohm Clara
Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
Cumming School of Medicine, University of Calgary, AB, Canada.
Can J Kidney Health Dis. 2025 Jan 3;12:20543581241309986. doi: 10.1177/20543581241309986. eCollection 2025.
Improving interactions between people receiving hemodialysis and health care providers of facility-based hemodialysis care is a top priority for patients, caregivers, and health care providers.
To identify challenges for high-quality clinical interactions in facility-based hemodialysis care as well as potential solutions.
Multicentre qualitative study using focus groups and semi-structured interviews to elicit the perspectives of patients, caregivers, and health care providers.
Five Canadian facility-based hemodialysis centers.
English-speaking adults receiving facility-based hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers.
Between May 2017 and August 2018, focus groups and interviews with patients and their caregivers subsequently informed semi-structured interviews with providers. Data were analyzed using inductive thematic analysis with application of a grounded theory approach.
A total of 8 focus groups and 44 interviews were completed. Participants included 64 people receiving hemodialysis, 18 caregivers, and 31 health care providers. Communication between health care providers and patients was often characterized as of care (unidirectional) rather than (bidirectional). Challenges were grouped into 4 main themes as follows: (1) culture of care provision; (2) mistrust between patients and health care providers; (3) time constraints for clinical interactions, and (4) lack of collaboration and care coordination among health care team. Potential solutions were identified for each challenge.
Findings were limited to Canadian context, English-speaking adults, and individuals receiving facility-based hemodialysis in urban centers.
Interactions between health care providers and people receiving dialysis are often unidirectional, where the patient is a passive recipient of ideas and information from the health care provider. To promote improved bidirectional interactions, team-based care that includes better tools to improve information transfer, better information regarding roles, and identity of health care team members and opportunities for all members of the health care team, including the people receiving dialysis, to provide input on care plans is required.
Not applicable.
改善接受血液透析的患者与机构性血液透析护理的医疗服务提供者之间的互动，是患者、护理人员和医疗服务提供者的首要任务。
确定机构性血液透析护理中高质量临床互动的挑战以及潜在解决方案。
采用焦点小组和半结构化访谈的多中心定性研究，以获取患者、护理人员和医疗服务提供者的观点。
加拿大的五个机构性血液透析中心。
接受机构性血液透析超过6个月的英语为母语的成年人、他们的护理人员以及血液透析医疗服务提供者。
2017年5月至2018年8月期间，先对患者及其护理人员进行焦点小组和访谈，随后对医疗服务提供者进行半结构化访谈。使用归纳主题分析法并应用扎根理论方法对数据进行分析。
共完成了8个焦点小组和44次访谈。参与者包括64名接受血液透析的患者、18名护理人员和31名医疗服务提供者。医疗服务提供者与患者之间的沟通通常被描述为关怀式（单向）而非互动式（双向）。挑战分为以下4个主要主题：（1）护理提供文化；（2）患者与医疗服务提供者之间的不信任；（3）临床互动的时间限制；（4）医疗团队之间缺乏协作和护理协调。针对每个挑战都确定了潜在的解决方案。
研究结果仅限于加拿大背景、英语为母语的成年人以及在城市中心接受机构性血液透析的个体。
医疗服务提供者与接受透析的患者之间的互动通常是单向的，患者是医疗服务提供者想法和信息的被动接受者。为了促进改善双向互动，需要基于团队的护理，包括更好的工具来改善信息传递、关于医疗团队成员角色和身份的更好信息，以及为包括接受透析的患者在内的所有医疗团队成员提供对护理计划提供意见的机会。
不适用。
