Patients’ Perspectives on Hemodialysis Vascular Access: A Systematic Review of Qualitative Studies

Non-attendance at clinical appointments is linked to fears about cannulation and dialysis access site generation.

“A qualitative systematic review showed non-attendance at clinical appointments was linked to fears about cannulation and dialysis access site generation (Casey et al . 2014).”

Behaviours described by haemodialysis patients as helpful for negotiating the complex self-management challenges of ESKD included acceptance of their appearance and the potential for health complications to occur and self-assertion with medical professionals.

“Behaviours described by haemodialysis patients as helpful for negotiating the complex self-management challenges of ESKD included: acceptance of their appearance and the potential for health complications to occur and selfassertion with medical professionals (Casey et al . 2014).”

Avoidance of social situations that had the potential to damage dialysis access sites and repeated checking behaviours for access site functionality were commonly initiated in response to concerns about future health complications.

“Likewise, avoidance of social situations that had the potential to damage dialysis access sites and repeated checking behaviours for access site functionality, were commonly initiated in response to concerns about future health complications (Casey et al . 2014).”

Qualitative reviews emphasise that ESKD diagnosis and procedures used to gain dialysis access are particularly anxiety provoking.

“Qualitative reviews emphasise ESKD diagnosis (Tong et al . 2013) and procedures used to gain dialysis access (Casey et al . 2014) are particularly anxiety provoking.”

Qualitative research identifies specific concerns in ESKD about pain and needles, the threat of complications at the dialysis access site, mistrust of unfamiliar health providers administering painful procedures, uncertainty whilst waiting for a transplant, and the 'unseen burden of ESKD' and its impact on social interactions with others.

“Other themes identified by qualitative research highlight specific concerns about pain and needles, the threat of complications at the dialysis access site, and mistrust of unfamiliar health providers administering painful procedures, uncertainty whilst waiting for a transplant, and the 'unseen burden of ESKD' and its impact on social interactions with others (Moran et al . 2011; Tong et al . 2013”