title: Facilitators and barriers to treatment with haemodialysis among persons in mid-adulthood: an interpretative phenomenological analysis.
abstract: BACKGROUND
  The quality of life of persons on haemodialysis (HD) is often limited by the restrictions imposed by their medical regimen. These restrictions may negatively influence patients' adherence to their treatment. Therefore, in an effort to improve patients' adherence to treatment, there is the need to explore the patients' perceptions of facilitators and barriers in relation to their experience of HD.
  
  
  OBJECTIVE
  The purpose of the study was to explore the perceived barriers and facilitators of the HD experience of persons in mid-adulthood.
  
  
  METHODS
  A qualitative design was used. Semistructured interviews were conducted with seven participants in the mid-adulthood phase (40-65 years). The transcribed texts were analysed using an Interpretative Phenomenological Analysis approach.
  
  
  RESULTS
  Three main themes were identified from the analysis: 'social network outside the renal unit', 'the renal setting as a context' and 'qualities relating to staff'. Facilitators identified include: support from family and work colleagues, caring and knowledgeable staff and consultation with patients when planning out the treatment schedule. Barriers to treatment include: discomfort with the needling process, intrusion of HD on family time, lack of privacy in the renal unit and staff that do not take their concerns seriously.
  
  
  CONCLUSIONS
  This study demonstrated the need for healthcare professionals to allocate time and space, where persons on HD may discuss personal issues that relate to their care experience in a private care setting. By identifying and exploring the barriers and facilitators of patients on haemodialysis, healthcare professionals may formulate individualised care plans which may improve patients' adherence to their HD treatment.
authors: Department of Nursing, Faculty of Health Sciences, University of Malta, Tal Qroqq, Malta.
authors: Alan
authors: A
authors: Sciberras
authors: Department of Mental Health, Faculty of Health Sciences, University of Malta, Tal Qroqq, Malta.|Faculty of Health, Social Care and Education, Kingston University, St George's, University of London, London, UK.
authors: Josianne
authors: J
authors: Scerri
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
keywords: haemodialysis; interpretative phenomenological analysis; lived experiences; qualitative