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How an ordeal becomes the norm: A qualitative exploration of experiences of self‐cannulation in male home haemodialysis patients
Author(s) -
Moore Currie,
MajeedAriss Rabiya,
Jayanti Anuradha,
Mitra Sandip,
Skevington Suzanne,
Wearden Alison
Publication year - 2018
Publication title -
british journal of health psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.05
H-Index - 88
eISSN - 2044-8287
pISSN - 1359-107X
DOI - 10.1111/bjhp.12303
Subject(s) - trial by ordeal , psychosocial , interpretative phenomenological analysis , medicine , qualitative research , psychology of self , norm (philosophy) , distancing , self esteem , psychology , nursing , clinical psychology , social psychology , psychotherapist , disease , covid-19 , social science , sociology , political science , law , infectious disease (medical specialty)
Objectives Despite home haemodialysis ( HHD ) being associated with significant health and psychosocial benefits, it remains an under‐utilized dialysis modality for people with chronic kidney disease. Self‐cannulation, where patients insert their own needles for dialysis, is a key component of HHD . Recent research suggests that the prospect of self‐cannulation is a barrier for patients, but there is little research which examines why this is the case. The aim of this study was to explore male HHD patients’ experiences and attitudes towards self‐cannulation. Design Qualitative methods were adopted to gather in‐depth views from experienced HHD patients from a UK renal centre. Methods Semi‐structured interviews were conducted with eight male HHD patients ( HHD duration: 12–55 months). During the interview, the researcher elicited participants’ lived experience of self‐cannulation. Topics included the decision to self‐cannulate and the impact of self‐cannulation on the patient. The data collected were analysed using interpretative phenomenological analysis. Results The findings from this study elucidate the process of how self‐cannulation changed from an ordeal to the norm in these participants’ lives. The central theme from these interviews is that ‘becoming a person who self‐cannulates is a process’. Three super‐ordinate themes were discussed that relate to this central theme: ‘gaining control’, ‘building confidence’, and ‘becoming the norm’. Conclusions The findings from this study suggest that some patients’ initial fears of self‐cannulation can be overcome. These findings offer health care professionals and patients alike a greater understanding of how patients who self‐cannulate conceptualize it and its role in their mental and physical health.Statement of contribution What is already known on this subject?Home haemodialysis is a cost‐effective form of renal replacement therapy which is under‐utilized in the United Kingdom. Home haemodialysis is associated with positive health outcomes. Self‐cannulation is noted as a barrier to home haemodialysis.What does this study add?Describes the process by which male dialysis patients became proficient in self‐cannulation. Highlights psychological mechanisms which may facilitate and maintain self‐cannulation. Suggests practical techniques which can be incorporated into renal clinics and care plans.