What are the qualitative experiences of people affected by kidney failure receiving haemodialysis: a meta-aggregation

Background: People affected by kidney failure receiving haemodialysis experience complexity within their health condition unlike any other chronic illness or condition. Kidney failure impacts the individual in all areas of their life including relationships and activities of daily living. Objective: To conduct a meta‐aggregation of studies about the lived experiences of people with kidney failure receiving haemodialysis. Design: Using PRISMA Guidelines, six databases (CINAHL, ClinicalTrials.gov, Cochrane Library, MEDLINE, PsycINFO, and Scopus) were comprehensively searched using keywords and subject headings from January 1990 to October 2021. Articles were assessed according to prespecified eligibility criteria. Data extraction and quality appraisal was conducted. A meta‐aggregation of qualitative findings was conducted using the Joanna Briggs Institute methodology for meta‐aggregation. Results: Of the 9409 articles screened, 55 studies were included. This represented a total of 188 findings across 45 categories representing a range of unmet supportive care needs. The meta‐aggregation identified 11 synthesised findings broadly related to psychological/emotional needs, physical needs, social needs, interpersonal/ intimacy needs, patient‐clinician communication needs, family related needs, health system/information needs, spiritual needs, daily living needs, practical needs and daily living needs.
Conclusions: This meta‐aggregation has identified that people affected by kidney failure can experience a range of unmet supportive care needs. It was evident that living with kidney failure and receiving haemodialysis impacted a person's sense of self, introduced practical needs and other complex needs which were not being addressed in existing services. This review has highlighted important implications for clinical practice and future research directions.