Lived experiences of patients receiving hemodialysis during the COVID-19 pandemic: A qualitative study

Abstract

Background: Hemodialysis patients have faced unique challenges during the COVID-19 pandemic. They face high risk of death if infected, and have unavoidable exposure to others when they come to hospital three times weekly for their life-saving treatments. The objective of this study was to gain a better understanding of the scope and magnitude of the impacts of the pandemic on the lived experience of patients receiving in-center hemodialysis. Methods: We conducted semi-structured interviews with 22 patients who were undergoing dialysis treatments in five hemodialysis centers in Montreal from Nov 2020 to May 2021. Interviews were transcribed and then analyzed using thematic content analysis. Results: Most participants reported no negative impacts of the COVID-19 pandemic on their hemodialysis care. Several patients had negative feelings related to forced changes in their dialysis schedules, and this was especially pronounced for indigenous patients in a shared living situation. Some patients were concerned about contracting COVID-19, especially during public transportation, while others expressed confidence that the physical distancing and screening measures implemented at the hospital would protect them and their loved ones. Some participants reported that masks negatively impacted their interactions with healthcare workers, and for many others, the pandemic was associated with feelings of loneliness. Finally, some respondents reported some positive impacts of the pandemic, including use of telemedicine, and creating a sense of solidarity. Conclusion: Patients undergoing hemodialysis reported no negative impacts on their medical care, but faced significant disruptions in their routines and social interactions due to the COVID-19 pandemic. Nevertheless, they showed great resilience in their ability to adapt to the new reality of their hemodialysis treatments. We also show that studies focused on understanding the lived experiences of indigenous patients and patients from different ethnic backgrounds are needed in order reduce inequities in care during public health emergencies.