title: Patients' experiences of safety during haemodialysis treatment--a qualitative study.
abstract: OBJECTIVE
  To explore the experiences of safety of adult patients during their haemodialysis treatment.
  
  
  BACKGROUND
  Haemodialysis is a complex treatment with a risk for harm that causes anxiety among many patients. To date, no in-depth study of haemodialysis patients' emotional responses to conditions of their treatment exists.
  
  
  METHODS
  A descriptive exploratory qualitative study using content analysis was conducted.
  
  
  METHODS
  Outpatients (≥18 years old) (n = 12) who were treated with haemodialysis for more than half a year were purposefully selected from two haemodialysis units (one in an academic hospital and one in a top clinical hospital) in the Netherlands. Data were collected through in-depth individual interviews from January-April 2013. Analysis of the transcribed interviews consisted of open coding, creating categories and synthesis.
  
  
  RESULTS
  Patients defined 'safety' as feeling safe from physical or emotional threats. Four main categories were identified in the descriptions of haemodialysis patients' experiences of safety: (a) insecurity; (b) trust in the nurse; (c) presence of the nurse; and (d) patients' need to control their situation.
  
  
  CONCLUSIONS
  Although haemodialysis patients perceived multiple risks, most patients reported feeling safe during their treatment. The nurse had a pivotal role in promoting patients' feelings of safety. Nurses should take into account patients' coping strategies because these coping strategies may cause some patients to feel anxious, especially when patients say that they leave everything to the nurse, yet they still desire control over their treatment.
authors.affiliation: Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, Nijmegen, The Netherlands.|Dialysis Department, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Marleen H
authors.initials: MH
authors.lastname: Lovink
authors.affiliation: Nursing Science, Program in Clinical Health Sciences, University Medical Center Utrecht, The Netherlands.|Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Marijke C
authors.initials: MC
authors.lastname: Kars
authors.affiliation: Nursing Science, Program in Clinical Health Sciences, University Medical Center Utrecht, The Netherlands.|Department of Rehabilitation, Nursing Science and Sport, University Medical Center Utrecht, The Netherlands.
authors.forename: Janneke M
authors.initials: JM
authors.lastname: de Man-van Ginkel
authors.affiliation: Faculty of Health Sciences, University of Southampton, UK.
authors.forename: Lisette
authors.initials: L
authors.lastname: Schoonhoven
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D061214:Patient Safety; D006435:Renal Dialysis / Q000523:psychology*; D012941:Social Responsibility; D035502:Trust; D055815:Young Adult
keywords: feeling safe; haemodialysis; nurses; nursing; patients’ experiences; qualitative study