Palliative Care Needs of Patients on Maintenance Hemodialysis at Thika Level 5 Hospital, Kiambu County, Kenya
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Date
2024-04
Authors
Githuku, Stephen N.
Onsongo, Lister
Mbuthia, Nickcy
Journal Title
Journal ISSN
Volume Title
Publisher
RJI
Abstract
Globally, a huge gap exists between the required and the available renal palliative care services. The gap is
particularly worse in low-and-medium income countries despite having the highest percentage of patients
requiring palliative care. Maintenance hemodialysis patients contribute a sizable percentage of the global
renal patient population in need of palliative care. Successful provision of adequate palliative care services
requires a holistic understanding of the patients’ needs. The purpose of this study was to explore the palliative
care needs of patients on maintenance hemodialysis at Thika Level 5 Hospital. A qualitative descriptive
design was used to explore the palliative care needs of the patients at the institution. Purposive sampling was
used to recruit participants. Data collection was conducted for a period of one month at the hospital’s renal
unit. A total of twelve maintenance hemodialysis patients participated in the study. Audiotaped semistructured interviews were used to conduct data collection. Thematic analysis was used to analyze the data.
The study findings showed that maintenance hemodialysis patients have many palliative care needs. The needs
regard to physical, psychological and social aspects. Distressing physical symptoms were identified as the
primary physical needs where fatigue, skin changes and fluctuations in appetite were reported as the most
prominent symptoms. Difficult thoughts related to uncertainty about the future, caregiver burden, inability to
get more children, stress and worry as well negative self-image were reported as the psychological needs
experienced by the patients. Interruption of social roles, abandonment by friends and financial burden on the
family were revealed as the social needs of the patients. To deal with their illness and treatment related
challenges, the patients primarily utilized spiritual coping where prayers were reported to be the most utilized
coping method. Lack of knowledge on palliative care and fear of being judged were identified as patient
related barriers to meeting palliative care needs of the patients. Understanding the palliative care needs of
maintenance hemodialysis patients has important implications on practice and policy making. Findings could
be used in developing renal palliative care services provision policies and protocols to use as a guide in the
identification and provision of palliative care to maintenance hemodialysis patients. Also, nephrology nurses
and other renal care team healthcare professionals could use the findings to develop strategies of addressing
patient related barriers to meeting palliative care needs. For research, studies could be done to evaluate the
influence and perspective of healthcare providers in the provision of palliative care to maintenance
hemodialysis
Description
Article
Keywords
Palliative Care, Hemodialysis
Citation
GITHUKU, S. N., ONSONGO, L., & MBUTHIA, N. (2024). Palliative care needs of patients on maintenance hemodialysis at Thika Level 5 Hospital, Kiambu County, Kenya. Reviewed International Journal of Medicine, Nursing & Public Health, 5(1), 47-64.