Original InvestigationDialysisPatient and Caregiver Perspectives on Home Hemodialysis: A Systematic Review
Section snippets
Methods
We followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework.22
Literature Search
The electronic search yielded 1,110 citations, of which 24 studies involving at least 221 patients (chronic kidney disease stages 4-5 predialysis [n = 15], hospital HD [n = 97], and home HD [n = 109]) and 121 caregivers of both home and hospital HD patients were eligible (Fig 1).
Comprehensiveness of Reporting
The comprehensiveness of study reporting was variable (Table 2). Studies reported on 1 (4%) to 24 (100%) items. Participant selection strategy was described in 21 (88%) studies. Theoretical saturation, defined as when little
Discussion
Patients and caregivers weigh the potential benefits of home-based dialysis against their anxieties and fears when making choices about home HD. Patients describe initially lacking confidence about their own ability to master home HD and voice fears about being isolated from medical support, their vulnerability if a medical catastrophe were to occur, and anxiety about specific aspects of home HD, particularly inserting needles. Concerns about the burden that home HD placed on their family
Acknowledgements
Support: Ms Walker is supported by a Sydney University APA Scholarship, New Zealand Lotteries Health Research Grant, Maurice and Phyllis Paykel Trust, and the Hawke’s Bay Medical Research Fund. Ms Hanson is supported by a postgraduate scholarship from Kidney Health Australia. Dr Palmer is supported by a Rutherford Discovery Fellowship from the Royal Society of New Zealand. Dr Morton is supported by an Australian National Health and Medical Research Council (NHMRC) Early Career Researcher
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