BMJ Open 4:e005020 doi:10.1136/bmjopen-2014-005020
  • Patient-centred medicine
    • Research

Patient satisfaction with in-centre haemodialysis care: an international survey

  1. Giovanni F M Strippoli2,3,6,7,8
  1. 1Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
  2. 2Consorzio Mario Negri Sud, S. Maria Imbaro, Italy
  3. 3School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  4. 4Division of Nephrology and Immunology, University of Alberta, Edmonton, Canada
  5. 5Scientific Institute Casa Sollievo della Sofferenza, Italy
  6. 6Diaverum Scientific Medical Office, Lund, Sweden
  7. 7Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
  8. 8Division of Nephrology and Transplantation, Department of Translational Medicine,Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
  1. Correspondence to Professor Giovanni F M Strippoli; gfmstrippoli{at}
  • Received 7 February 2014
  • Revised 28 April 2014
  • Accepted 30 April 2014
  • Published 19 May 2014


Objectives To evaluate patient experiences of specific aspects of haemodialysis care across several countries.

Design Cross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire.

Setting Haemodialysis clinics within a single provider in Europe and South America.

Participants 2748 adults treated in haemodialysis.

Primary and secondary outcomes The primary outcome was patient satisfaction with overall care. Secondary outcomes included patient experiences of individual aspects of dialysis care.

Results 2145 (78.1%) adults responded to the questionnaire. Fewer than half (46.5% (95% CI 44.5% to 48.6%)) rated their overall care as excellent. Global perceptions of care were uninfluenced by most respondent characteristics except age and depressive symptoms; older respondents were less critical of their care (adjusted OR for excellent rating 1.44 (1.01 to 2.04)) and those with depressive symptoms were less satisfied (0.56 (0.44 to 0.71)). Aspects of care that respondents most frequently ranked as excellent were staff attention to dialysis vascular access (54% (52% to 56%)); caring of nurses (53% (51% to 55%)); staff responsiveness to pain or discomfort (51% (49% to 53%)); caring, helpfulness and sensitivity of dialysis staff (50% (48% to 52%)); and ease of reaching dialysis staff by telephone (48% (46% to 50%)). The aspects of care least frequently ranked as excellent were information provided when choosing a dialysis modality (23% (21% to 25%)), ease of seeing a social worker (28% (24% to 32%)), information provided about dialysis (34% (32% to 36%)), accuracy of information from nephrologist (eg, about prognosis or likelihood of a kidney transplant; 37% (35% to 39%)) and accuracy of nephrologists’ instructions (39% (36% to 41%)).

Conclusions Haemodialysis patients are least satisfied with the complex aspects of care. Patients’ expectations for accurate information, prognosis, the likelihood of kidney transplantation and their options when choosing dialysis treatment need to be considered when planning healthcare research and practices.

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