Background: Little is known about the contemporary definitions of non-adherence to renal dialysis as understood by experienced renal nurses and applied in clinical practice. Identifying definitions of nonadherence to dialysis will lead to further investigation of converging patient definitions, opportunities to improve clinical practice and patient outcomes.
Aim: This study aims to define non-adherence across dialysis types as reported by experienced renal nurses and to investigate consistency of definitions, intervention strategies and clinical reporting policies.
Methods: This is a qualitative study of how adherence is understood by nurses from The HOME Network (THN), a national initiative to promote home dialysis. Qualitative thematic analysis of verbatim transcripts of in-depth semi-structure interviews with these expert nurses were used to elicit data to descript how nurses define adherence in clinical settings providing support for renal dialysis patients.
Results: Nine nursing members of THN (70%) consented to the semi-structure interviews. Interviewing for the purpose of qualitative analysis continued until saturation was reached, as agreed by the research team. Several themes emerged in relation to non-adherence to dialysis: Contributing factors to non-adherence; socioeconomic and psychological, training and non-adherence, markers of non-adherence, interventions and management of non-adherence.
Conclusion: This study has demonstrated that definitions of non-adherence to dialysis as perceived by experienced nurses include multiple and complex factors impacting sustainable and successful treatment. Future research will be conducted to understand patient perceptions about what nonadherence means to them to promote shared understandings between patient and clinician to improve outcomes and management.