hemodialysis adequacy sacrificed for business: a qualitative study

Background: dialysis adequacy is a predictor for mortality and morbidity in patients undergoing hemodialysis. previous studies pinpointed several factors as barriers to adequate dialysis. however, there is a scarcity of studies investigating the experiences of patients undergoing hemodialysis and health care providers (e g, dialysis nurses and nephrologists) with regards to high-quality dialysis barriers. the current study aimed at gaining a deeper understanding regarding the experiences of patients undergoing hemodialysis and dialysis professionals about the subjective barriers to hemodialysis adequacy. methods: the current study was conducted using the conventional content analysis method; 19 patients undergoing hemodialysis, 2 hemodialysis caregivers, 2 hemodialysis nurses, and 2 nephrologists were included and interviewed. results: based on the obtained data, 993 initial codes were extracted under four categories: barrier of self, social support insufficiency, hemodialysis mafia, and supervision weakness. conclusions: patients undergoing hemodialysis and health care providers have different experiences compared with what is mentioned in textbooks about barriers to high-quality dialysis. the findings highlight theneed for immediate re-examination and preparation of the standards for the quality of hemodialysis, as well as attention and focus on non-physiological barriers to dialysis adequacy.