Patient satisfaction with in-centre haemodialysis care: an international survey.
OBJECTIVE
To evaluate patient experiences of specific aspects of haemodialysis care across several countries.


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


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


METHODS
2748 adults treated in haemodialysis.


METHODS
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.
Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
Suetonia C
SC
Palmer
Consorzio Mario Negri Sud, S. Maria Imbaro, Italy.
Giorgia
G
de Berardis
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Jonathan C
JC
Craig
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Allison
A
Tong
Division of Nephrology and Immunology, University of Alberta, Edmonton, Canada.
Marcello
M
Tonelli
Consorzio Mario Negri Sud, S. Maria Imbaro, Italy Scientific Institute Casa Sollievo della Sofferenza, Italy.
Fabio
F
Pellegrini
Diaverum Scientific Medical Office, Lund, Sweden.
Marinella
M
Ruospo
Diaverum Scientific Medical Office, Lund, Sweden.
Jörgen
J
Hegbrant
Diaverum Scientific Medical Office, Lund, Sweden.
Charlotta
C
Wollheim
Diaverum Scientific Medical Office, Lund, Sweden.
Eduardo
E
Celia
Diaverum Scientific Medical Office, Lund, Sweden.
Ruben
R
Gelfman
Diaverum Scientific Medical Office, Lund, Sweden.
Juan Nin
JN
Ferrari
Diaverum Scientific Medical Office, Lund, Sweden.
Marietta
M
Törok
Diaverum Scientific Medical Office, Lund, Sweden.
Marco
M
Murgo
Diaverum Scientific Medical Office, Lund, Sweden.
Miguel
M
Leal
Diaverum Scientific Medical Office, Lund, Sweden.
Anna
A
Bednarek-Skublewska
Diaverum Scientific Medical Office, Lund, Sweden.
Jan
J
Dulawa
Consorzio Mario Negri Sud, S. Maria Imbaro, Italy School of Public Health, University of Sydney, Sydney, New South Wales, Australia Diaverum Scientific Medical Office, Lund, Sweden Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy Division of Nephrology and Transplantation, Department of Translational Medicine,Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
Giovanni F M
GF
Strippoli
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006436:Hemodialysis Units, Hospital; D006801:Humans; D038622:Internationality; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D055815:Young Adult