Living with frailty and haemodialysis: a qualitative study
Abstract Background Frailty is highly prevalent in people receiving haemodialysis (HD) and is associated with poor outcomes. Understanding the lived experiences of this group is essential to inform holistic care delivery. Methods Semi-structured interviews with N = 25 prevalent adults receiving HD f...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-022-02857-w |
| _version_ | 1828259684970135552 |
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| author | Hannah M. L. Young Nicki Ruddock Mary Harrison Samantha Goodliffe Courtney J. Lightfoot Juliette Mayes Andrew C. Nixon Sharlene A. Greenwood Simon Conroy Sally J. Singh James O. Burton Alice C. Smith Helen Eborall |
| author_facet | Hannah M. L. Young Nicki Ruddock Mary Harrison Samantha Goodliffe Courtney J. Lightfoot Juliette Mayes Andrew C. Nixon Sharlene A. Greenwood Simon Conroy Sally J. Singh James O. Burton Alice C. Smith Helen Eborall |
| author_sort | Hannah M. L. Young |
| collection | DOAJ |
| description | Abstract Background Frailty is highly prevalent in people receiving haemodialysis (HD) and is associated with poor outcomes. Understanding the lived experiences of this group is essential to inform holistic care delivery. Methods Semi-structured interviews with N = 25 prevalent adults receiving HD from 3 HD units in the UK. Eligibility criteria included a Clinical Frailty Scale (CFS) score of 4–7 and a history of at least one fall in the last 6 months. Sampling began guided by maximum variation sampling to ensure diversity in frailty status; subsequently theoretical sampling enabled exploration of preliminary themes. Analysis was informed by constructivist grounded theory; later we drew upon the socioecological model. Results Participants had a mean age of 69 ± 10 years, 13 were female, and 13 were White British. 14 participants were vulnerable or mildly frail (CFS 4–5), and 11 moderately or severely frail (CFS 6–7). Participants characterised frailty as weight loss, weakness, exhaustion, pain and sleep disturbance arising from multiple long-term conditions. Participants’ accounts revealed: the consequences of frailty (variable function and psychological ill-health at the individual level; increasing reliance upon family at the interpersonal level; burdensome health and social care interactions at the organisational level; reduced participation at the community level; challenges with financial support at the societal level); coping strategies (avoidance, vigilance, and resignation); and unmet needs (overprotection from family and healthcare professionals, transactional health and social care exchanges). Conclusions The implementation of a holistic needs assessment, person-centred health and social care systems, greater family support and enhancing opportunities for community participation may all improve outcomes and experience. An approach which encompasses all these strategies, together with wider public health interventions, may have a greater sustained impact. Trial registration ISRCTN12840463 . |
| first_indexed | 2024-04-13T03:12:14Z |
| format | Article |
| id | doaj.art-9aa796979ba440f9a8ab47f85e73455f |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-13T03:12:14Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-9aa796979ba440f9a8ab47f85e73455f2022-12-22T03:05:00ZengBMCBMC Nephrology1471-23692022-07-0123111210.1186/s12882-022-02857-wLiving with frailty and haemodialysis: a qualitative studyHannah M. L. Young0Nicki Ruddock1Mary Harrison2Samantha Goodliffe3Courtney J. Lightfoot4Juliette Mayes5Andrew C. Nixon6Sharlene A. Greenwood7Simon Conroy8Sally J. Singh9James O. Burton10Alice C. Smith11Helen Eborall12Leicester Diabetes Centre, University Hospitals of Leicester NHS TrustJohn Walls Renal Unit, University Hospitals of Leicester NHS TrustLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustSchool of Health, Wellbeing and Social Care, The Open UniversityDepartment of Health Sciences, University of LeicesterDepartment of Physiotherapy and Renal Medicine, King’s College Hospital and Department of Renal Medicine, King’s College LondonDepartment of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation TrustDepartment of Physiotherapy and Renal Medicine, King’s College Hospital and Department of Renal Medicine, King’s College LondonCentral and North West London NHS Foundation Trust - MRC Unit for Lifelong Health and Ageing, University College LondonCentre for Exercise & Rehabilitation Science, NIHR Leicester Biomedical Research CentreDepartment of Cardiovascular Sciences, University of LeicesterDepartment of Health Sciences, University of LeicesterUsher Institute, University of EdinburghAbstract Background Frailty is highly prevalent in people receiving haemodialysis (HD) and is associated with poor outcomes. Understanding the lived experiences of this group is essential to inform holistic care delivery. Methods Semi-structured interviews with N = 25 prevalent adults receiving HD from 3 HD units in the UK. Eligibility criteria included a Clinical Frailty Scale (CFS) score of 4–7 and a history of at least one fall in the last 6 months. Sampling began guided by maximum variation sampling to ensure diversity in frailty status; subsequently theoretical sampling enabled exploration of preliminary themes. Analysis was informed by constructivist grounded theory; later we drew upon the socioecological model. Results Participants had a mean age of 69 ± 10 years, 13 were female, and 13 were White British. 14 participants were vulnerable or mildly frail (CFS 4–5), and 11 moderately or severely frail (CFS 6–7). Participants characterised frailty as weight loss, weakness, exhaustion, pain and sleep disturbance arising from multiple long-term conditions. Participants’ accounts revealed: the consequences of frailty (variable function and psychological ill-health at the individual level; increasing reliance upon family at the interpersonal level; burdensome health and social care interactions at the organisational level; reduced participation at the community level; challenges with financial support at the societal level); coping strategies (avoidance, vigilance, and resignation); and unmet needs (overprotection from family and healthcare professionals, transactional health and social care exchanges). Conclusions The implementation of a holistic needs assessment, person-centred health and social care systems, greater family support and enhancing opportunities for community participation may all improve outcomes and experience. An approach which encompasses all these strategies, together with wider public health interventions, may have a greater sustained impact. Trial registration ISRCTN12840463 .https://doi.org/10.1186/s12882-022-02857-wHaemodialysisFrailtyDialysisMulti-morbidityQualitativeInterviews |
| spellingShingle | Hannah M. L. Young Nicki Ruddock Mary Harrison Samantha Goodliffe Courtney J. Lightfoot Juliette Mayes Andrew C. Nixon Sharlene A. Greenwood Simon Conroy Sally J. Singh James O. Burton Alice C. Smith Helen Eborall Living with frailty and haemodialysis: a qualitative study BMC Nephrology Haemodialysis Frailty Dialysis Multi-morbidity Qualitative Interviews |
| title | Living with frailty and haemodialysis: a qualitative study |
| title_full | Living with frailty and haemodialysis: a qualitative study |
| title_fullStr | Living with frailty and haemodialysis: a qualitative study |
| title_full_unstemmed | Living with frailty and haemodialysis: a qualitative study |
| title_short | Living with frailty and haemodialysis: a qualitative study |
| title_sort | living with frailty and haemodialysis a qualitative study |
| topic | Haemodialysis Frailty Dialysis Multi-morbidity Qualitative Interviews |
| url | https://doi.org/10.1186/s12882-022-02857-w |
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