title: Transformations: a phenomenological investigation into the life-world of home haemodialysis.
abstract: With a growth in home-care, and increased funding for dialysis, there is a need for the field of Social Work to understand the life-world of people who experience home haemodialysis technology (HDDT). Given little research has focussed on the lived-experiences of this population (Nagle, 1995), an exploratory qualitative study was employed (Strauss & Corbin, 1998). The study investigated the embodied life-world experiences of this population using phenomenological methods (Kvale, 1996; van Manen, 1997). The data was collected and analyzed in terms of the four basic phenomenological categories of lived-time, lived-body, lived-spatiality, lived-relations with others and self (van Manen, 1997). A purposive sample of four was selected, and interviewed using semi-structured interviews, with each participant experiencing various lengths of HHDT. The findings revealed that their life-world had been transformed by their experience of HHDT. In particular, it was documented how participants' adoption of medical practice and discourse has impacted the lived-body, suggesting a need to adopt a plain language or holistic medical discourse practice approach for communication with patients which supports bodily-integrity and sovereignty. Additional findings centered on the incorporation of HHDT into the family unit, and how HHDT may present a health care access barrier to those without homes. Moreover, aspects of the transformation of the home into a hospital were highlighted. Finally, it is suggested that social assessment should consider the patient and family's experience of the dialysis machine.
authors.affiliation: Nephrology Social Work, Toronto General Hospital, University Health Network, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Giles
mesh_terms: D002170:Canada; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006437:Hemodialysis, Home; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D009313:National Health Programs; D036301:Qualitative Research; D012947:Social Work