Sign Up

Patient and caregiver perspectives on home hemodialysis: A systematic review

NZ Literature Abstract

posted by WM Admin on 28 January 2015


Rachael Walker
Camilla S. Hanson
Suetonia Palmer
Kirsten Howard
Rachael L. Morton
Mark R. Marshall
Allison Tong

Year of Publication



American Journal of Kidney Disease, 65(3), 451–463

Publication Type

Journal article (peer reviewed)

Publication Status



In this systematic review of qualitative studies, the authors describe patient and caregiver perspectives and experiences of home home hemodialysis (HD) to inform home HD programmess that align with patient preferences. Twenty-four studies involving 221 patients (109 home HD; 97 hospital HD, and 15 predialysis) and 121 caregivers were eligible. The authors "... identified 5 themes: vulnerability of dialyzing independently (fear of self-needling, feeling unqualified, and anticipating catastrophic complications), fear of being alone (social isolation and medical disconnection), concern of family burden (emotional demands on caregivers, imposing responsibility, family involvement, and medicalizing the home), opportunity to thrive (re-establishing a healthy self-identity, gaining control and freedom, strengthening relationships, experiencing improved health, and ownership of decision), and appreciating medical responsiveness (attentive monitoring and communication, depending on learning and support, developing readiness, and clinician validation)". The authors conclude that acknowledging and addressing apprehensions could better support patients and caregivers considering home HD.

Type of Study

Systematic review

How to Access

To read the full abstract, and for information on how to access the full text, go to: or contact your DHB library, or organisational or local library for assistance.