Patientdelaktighet inom hemodialysvård – En systematisk litteraturstudie
Sammanfattning: Backround: In Sweden just over 3200 people are treated with haemodialysis. The treatment is usually performed 3 times per week, 3-5 hours per session. Kidney-and dialysis care stands out from other treatments and chronic diseases in that way that it brings a great restraint and need for adaptation for the individual. Person-centered care and patient participation are concepts that today has become central in Swedish law texts and policies, and are looked upon by Swedish citizen as a basis for good care. Yet nothing so far indicates that the status of the patient has improved in practice. Aim: The aim of the study was to describe the endorsing and hindering of patient participation within the setting of haemodialysis. Method: The study was conducted as a systematic literature review of 14 qualitative primary studies which were published between 2010-2020. Result: The conducted qualitative context analysis led to four mainthemes:“Body or life”, “In a vulnerablesituation”, “Participation through knowledge”and “the Nursing relationship”. The result showed that participation was endorsed if the patient found an acceptance of disease and treatment, and if the staff valued the patients experience and self-care resources. Obstacles for participation included the disadvantage for patients in terms of knowledge within an advanced care environment and burden of symptoms and vulnerability, but also the traditional hierarchical setting of care, lack of resources and nurses adapting a caring role. Conclusion and implication: The conclusion and clinical implication for nursing staff includes the value of using the patients resources, make sure that the patient receives an adequate knowledge base and that the medical understanding gets adjusted to the patients’ life and person.
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