Patients’ and carers’ experiences of interacting with home haemodialysis technology: implications for quality and safety

BMC Nephrology

Research Article

Ken Farrington¹  Diane Walker²  Atish Rajkomar³  Ann Blandford³  Astrid Mayer⁴ 

[1] Renal Medicine, East and North Hertfordshire NHS Trust, Stevenage, UK;Renal Unit, Royal Free Hospital, London, UK;UCL Interaction Centre, University College London, London, UK;UCL Medical School, University College London, London, UK;

关键词: Home haemodialysis;    Human factors;    Medical device design;    Patient safety;    Patient satisfaction;    User-computer interface;   

DOI  :  10.1186/1471-2369-15-195

 received in 2014-08-29, accepted in 2014-11-27,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundLittle is known about patients’ and carers’ experiences of interacting with home haemodialysis (HHD) technology, in terms of user experience, how the design of the technology supports safety and fits with home use, and how the broader context of service provision impacts on patients’ use of the technology.MethodsData were gathered through ethnographic observations and interviews with 19 patients and their carers associated with four different hospitals in the UK, using five different HHD machines. All patients were managing their condition successfully on HHD. Data were analysed qualitatively, focusing on themes of how individuals used the machines and how they managed their own safety.ResultsFindings are organised by three themes: learning to use the technology, usability of the technology, and managing safety during dialysis. Home patients want to live their lives fully, and value the freedom and autonomy that HHD gives them; they adapt use of the technology to their lives and their home context. They also consider the machines to be safe; nevertheless, most participants reported feeling scared and having to learn through mistakes in the early months of dialysing at home. Home care nurses and technicians provide invaluable support. Although participants reported on strategies for anticipating problems and keeping safe, perceived limitations of the technology and of the broader system of care led some to trade off safety against immediate quality of life.ConclusionsEnhancing the quality and safety of the patient experience in HHD involves designing technology and the broader system of care to take account of how individuals manage their dialysis in the home. Possible design improvements to enhance the quality and safety of the patient experience include features to help patients manage their dialysis (e.g. providing timely reminders of next steps) and features to support communication between families and professionals (e.g. through remote monitoring).

【 授权许可】

Unknown   
© Rajkomar et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.