Patients' perspectives on key aspects influencing needling for haemodialysis: A qualitative study

Abstract

Background: For many patients, cannulation ('needling') is essential for haemodialysis. It is associated with anxiety and fear and contributes to the overall burden of treatment. Limited research exists on patient experience of needling and how this might vary by individual and clinical characteristics. Objectives: To explore and identify key aspects of needling impacting patients' experiences. Design: Qualitative, multicentre, cross-sectional, co-produced. Participants: Adults on haemodialysis with working fistulae or grafts (n = 41). Approach: We used interviews to explore patients' experiences of needling and key aspects contributing to this. Interviews were conducted in two sets: unstructured (n = 24, broadly investigated needling experience) and semistructured (n = 17, refined themes and assessed cultural relevance). Thematic analysis was used to identify themes driving experience and examine variation. A Patient Steering Group comprising people with lived experience of needling was integral to the study. Findings: A thematic framework capturing patients' view of needling was developed. It defined a core theme (The Nature of needling) and five foundational aspects of needling (Health of the fistula or graft, Steps in needling, The needler, The patient, Organisational context). We identified two further themes important to overall experience, Learning from needling experience and Reciprocity (the two-way interaction between patient and needler). Both interrelated across themes, highlighting the complexity of needling and junctures where patient experience can be influenced. Conclusions: Needling is shaped by multiple psychological and relational influences. These findings provide healthcare professionals with a basis to improve patient experience as part of a broader drive to enhance quality in healthcare delivery.

Publication DOI: https://doi.org/10.1111/jorc.12513
Divisions: College of Business and Social Sciences
College of Business and Social Sciences > Aston Business School
Aston University (General)
Funding Information: National Institute for Health and Care Research Research for Patient Benefit (RfPB) Programme. Grant Number: PB-PG-0418-20047
Additional Information: Copyright © 2024 The Author(s). Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association. This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium,provided the original work is properly cited.
Uncontrolled Keywords: cannulation,chronic kidney disease,co-production,haemodialysis,vascular access,Nephrology,Advanced and Specialised Nursing
Publication ISSN: 1755-6686
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Additional supporting information may be found in the online version of this article at the publisher's web-site.
Last Modified: 01 Apr 2025 07:11
Date Deposited: 25 Nov 2024 18:16
Full Text Link:
Related URLs: https://www.sco ... tnerID=8YFLogxK (Scopus URL)
https://onlinel ... 1111/jorc.12513 (Publisher URL)
PURE Output Type: Article
Published Date: 2024-12
Published Online Date: 2024-11-11
Accepted Date: 2024-10-01
Authors: Moore, Currie
Ellis-Caird, Helen
Fielding, Catherine
Awan, Faizan
Paul, Tarsem
Flanagan, Rebecca
Sharma, Shivani (ORCID Profile 0000-0002-7682-2858)
McCafferty, Kieran
Veer, Sabine N.van der
Farrington, Ken
Wellsted, David

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