How does the experience of haemodialysis impact a patient’s ability to cope with a fear of needles and the needling procedure?

Abstract

Haemodialysis is the most common treatment used to prolong the life of patients living with kidney disease. This requires three treatments a week, with two large needles inserted at each treatment. There has been limited investigation into the causes of needle distress in dialysis patients, so it is difficult to implement appropriate interventions to address this issue. The aim of this study is to explore patient fear around needles and identify processes to better manage the fear of needles. I aim to answer the question, how does the experience of haemodialysis impact a patient’s ability to cope with a fear of needles and the needling procedure? Interview data from fifteen haemodialysis patients was provided by the Central Northern Adelaide Renal and Transplantation Service (CNARTS). The interviews went thorough a thematic analysis coding process and were ultimately grouped into five overarching themes. These interviews were analysed under the theoretical lens of the transactional model of stress and coping, with three coping methods, emotional-, task- and avoidance oriented, to explore the coping of haemodialysis patients. The central themes were, Challenges with the physical procedure, Emotional responses to sources of pain, Regaining control through self-reliance, Improved outcomes through patient-centred care and Influence of nursing skills on psychological outcomes. This study will provide valuable insight into the mechanisms that affect patent coping during dialysis, and the data can be used in the development of a patient-led and nurse-supported intervention to be delivered by a health psychologist to address needle fear in dialysis patients.