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The experiences of patients receiving haemodialysis treatment in an open setting environment at an academic hospital in Johannesburg

BACKGROUND: Patients receiving haemodialysis (HD) treatment experience a significant
symptom burden and their needs are multifaceted. In HD unit, patients receive treatment in a
diverse cultural and open ward setting. However, patients‟ experiences of receiving HD
treatment in an open ward setting are not known.
OBJECTIVES: The central aim of this study was to explore and describe the experiences of
patients receiving HD treatment in an open setting environment at an academic hospital in
Johannesburg.
DESIGN: A qualitative, exploratory and descriptive study was conducted at a public, tertiary
level academic hospital in Johannesburg after obtaining ethical approval from Wits University
and relevant authorities.
SETTING: The research setting for this study was an adult Chronic Renal Dialysis Unit.
POPULATION: Sixteen adult (age 18 and above) patients receiving chronic HD treatment
were recruited purposively in this study.
INTERVENTIONS: An in-depth semi-structured interview was conducted either before or
after receiving HD treatment, which was audio-recorded, transcribed then analysed by using
Giorgi Phenomenological method.
FINDINGS: A mood enhancer appeared a major theme as participants positively valued the
open setting environment for their overall and psychological well-being. Participants
expressed by being with others and sharing experiences, a sense of community likened to a
family developed. Common to all participants‟ language was the use of the “we” in relation to
being in the open setting environment. This expression of the “we” by participants was
interpreted as a community concept. The use of “we” associated with the concept of
community described as a space to which every patient receiving HD belonged. They
described their experiences in a collective manner. This was evident in repetitive reference to
their common space, being together, sharing experiences, and finding identity from one
another, being understood and a sense of being protected with personal relations that extend
beyond 10 years for some.
This open space contributed to shaping their perception of body image and illness. The nurse‟s
role in timeously providing HD care was appreciated by many.
However, being exposed to multiple situations of chronic illness and treatment a sense of fear
developed. Any negative event experienced, watched, observed, or heard in the HD unit
triggered fear in the patients. Two common fears were of HD complications and the constant
threat of death. Complications such as clotting, muscle cramps and collapsing because of
hypotension as well as watching somebody dying on the machine were all reported in this
study and so psychological counselling was felt to be very important.
CONCLUSION
The recommendations proposed in this study hopefully will assist HD staff to intervene and
make adjustments to support patients‟ holistic needs. Further studies into patients receiving
HD in open settings and mixed-gender space are required for diversity of experiences and
knowledge from different settings.
Keywords: Haemodialysis, hospital environment, open setting, patient experiences

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/15260
Date26 August 2014
CreatorsKhomba, Mayamiko Munthali
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf

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