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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | 538-551 |
| Number of pages | 14 |
| Journal | Journal of Renal Care |
| Volume | 50 |
| Issue number | 4 |
| Early online date | 11 Nov 2024 |
| DOIs | |
| Publication status | Published - Dec 2024 |
Bibliographical note
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.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.Keywords
- cannulation
- chronic kidney disease
- co-production
- haemodialysis
- vascular access