Understanding the Personal Experiences of Patients on Hemodialysis
Bibliographic record
Abstract
Background: Patients with end stage kidney disease on hemodialysis (HD) have complex medical, social, and emotional needs. The symptom burden of patients on HD is well documented; however, literature has not fully described the holistic patient experience, such as the social and emotional impact of HD. The objective of this study is to capture the lived experiences of patients on HD, including effects on their emotional health, relationships, and quality of life. Methods: This is a qualitative study. Patients on chronic HD in Hamilton, Ontario were invited to participate. Semi-structured interviews were conducted to understand the effect of HD on their emotional and mental health, and quality of life. Interviews were transcribed and coded to identify emerging themes. A framework of the impact of HD was developed using constructivist grounded theory. Results: 16 interviews were completed as of January 2022. Three themes were identified: 1) expectations of HD, 2) personal and profession impacts, and 3) changes in personal identity (Figure 1). Participants felt their experiences on HD were different from their expectations based on counselling provided by healthcare staff. This included positive and negative experiences. Participants experienced loss of employment opportunities, intimate relationships, and hobbies since starting HD. Some participants noted the emergence of a new identity anchored to HD due to the significant role it played in their lives.Figure 1:: Professional and personal impact of hemodialysis on identity formation.Conclusions: Initiating HD leads to unanticipated losses for patients both personally and professionally. This requires them to undergo a number of complex changes to accommodate HD in their lives. The impact of these changes are far reaching, resulting in patients taking new identities as they cope with their chronic health concerns. Overall, this data provides new insight on the patient experience, and can be used to engage in meaningful conversations about initiation of HD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.007 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".