Nyabaro, Doreen2024-09-272024-09-272024-05https://ir-library.ku.ac.ke/handle/123456789/28921A Thesis Submitted In Partial Fulfilment of The Requirement for the Award of the Degree of Master of Science (Nephrology Nursing) in the School of Health Sciences Department of Medical Surgical Nursing and Pre-Clinical Sciences, Kenyatta University May, 2024 Supervisors: 1. Grace Githemo 2. Lister OnsongoBackground: Hemodialysis is a common management intervention in patients with Chronic Kidney Disease and End-Stage Renal Disease. Globally, there are approximately 1 billion renal patients on hemodialysis. Despite the increase in utilization of maintenance hemodialysis in low- and medium-income countries, there have been fewer efforts to assess the quality of hemodialysis services. Thus, there is a need to assess the quality of hemodialysis services. Objective: To evaluate the quality of hemodialysis services at selected county dialysis centers. Methodology: The study was a cross-section descriptive study. The study adopted a census method where 118 hemodialysis patients was considered. The participants were sampled consecutively based on the inclusion criteria. SERV-QUAL tool was used to measure perceived quality of hemodialysis services. Chi squares test for the association was used to determine the association between the patient, institutional factors, healthcare professional factors, and the quality of Hemodialysis services. Binary logistic regression analysis was used to determine predictors of quality hemodialysis services. Statistical Package for Social Sciences (SPSS version 26) was used for data analysis. Results: Majority of the patients 61.9%(n =73)were male, with 28.8%(n =34) of the respondents being aged 60 years and above. The findings further showed that 44.1% of the participants had secondary level education. The perceived quality of hemodialysis services was moderate with 56%. Bivariate analysis revealed that gender, level of education, presence of comorbidities, admission due to side effects, receiving social support, waiting time, receiving education before dialysis session and satisfaction with care were associated with quality of hemodialysis services. Multivariate analysis using logistic regression established that being male (AOR =3.75, 95%CI: 1.11 – 12.64, p =0.033), having secondary level education (AOR =2.31, 95%CI: 1.41 – 4.97, p =0.046), having been admitted due to side effects since the beginning of hemodialysis sessions (AOR =0.22, 95%CI:0.15 – 0.86, p<0.001), having received social support from family and friends (AOR =11.49, 95%CI: 1.79 -73.95, p =0.010) and not waiting longer to be allocated a HD (AOR = 0.21, 95%CI: 0.05 – 0.93, p =0.041) were significant predictors of perceived good quality of hemodialysis services: Conclusion and recommendation: The perceived quality of hemodialysis services remains moderate. Gender, education level, admission due to side effects waiting time and receiving social have been identified as predictors of perceived quality of hemodialysis services. Therefore, increased health education, training more staff on the needs of patients and reviewing appointment period based on the number of machines available is essential to improved care.enThesis