Abstract: TH-PO264
Exploring the Adoption of Thrice-Weekly, Extended-Hours, In-Center, Nocturnal Hemodialysis in Routine Clinical Practice through the NightLife Study: A Qualitative Content Analysis
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Hull, Katherine Leigh, University of Leicester Department of Cardiovascular Sciences, Leicester, United Kingdom
- Cluley, Victoria, University of Nottingham School of Sociology and Social Policy, Nottingham, United Kingdom
- Graham-Brown, Matthew, University of Leicester Department of Cardiovascular Sciences, Leicester, United Kingdom
- Burton, James, University of Leicester Department of Cardiovascular Sciences, Leicester, United Kingdom
Background
In-centre nocturnal haemodialysis (INHD) is a complex intervention and little is known about the factors influencing implementation. NightLife (ISRCTN87042063) is a randomised controlled trial comparing the clinical and cost-effectiveness of INHD to usual care. This study aims to understand the facilitators and barriers to INHD adoption within the NightLife trial, focusing on the infrastructure, research environment and healthcare professional perspective.
Methods
This study was completed as a qualitative content analysis, using an inductive approach following Braun and Clarke’s framework for reflexive thematic analysis. Content for analysis was derived over a three-year period from three business cases, 80 e-mail discussions (each discussion containing one to 10 e-mails), one internal pilot report, 60 meeting minutes, and seven semi-structured interviews with members of the multidisciplinary team.
Results
Four key themes were identified:
1. Inequity: differential access to healthcare resources specific to dialysis treatment.
2. Role of knowledge and evidence: the impact of known benefits of INHD and the need for more research.
3. Staff perception and experience: motivation to start and continue with INHD site set-up.
4. Resources, support and complexity: multiple logistical challenges to negotiate and the impact of support from clinical and research teams.
These four themes contributed to both the adoption and non-adoption of INHD within the NightLife study.
Conclusion
Site set-up and INHD service delivery have been the greatest challenges to NightLife study progression. Although each site appears to have unique challenges, this qualitative content analysis demonstrates commonality in the facilitators and barriers to dialysis service innovation. Utilising these findings will support site set-up of INHD within the NightLife study and are transferable to the development and evaluation of future complex interventions for the dialysis community.