Patients’ experience one year after dialysis initiation: a lexicometric analysis

BACKGROUND: Dialysis implies huge changes in patients’ lives. Yet, there is a need to better understand patients’ experience in the time following dialysis initiation. OBJECTIVE: The objective of this study was to investigate patients’ experience of dialysis a year after treatment initiation and the associations between patients’ discourse and their anxiety and depression symptoms. METHODS: Twenty two patients (mean age 63.4; 68% men) took part in a semi-directed interview about their experience with dialysis. Participants completed the Hospital Anxiety and Depression Scale (HADS). Interviews were analyzed using a lexicometric analysis. RESULTS: The analysis generated five classes: experience with nephrological care, facing loss and family relationships, family and acceptance, implementation of a new routine and making sense of the end-stage renal disease experience. Patients’ felt very passive in their experience with care. They reported the importance of integrating dialysis in their lives and the role of family support when facing treatment initiation. Depressed patients were more likely to describe their nephrological monitoring very factually and to talk about what they lost with dialysis initiation. CONCLUSION: Dialysis initiation is a hard time for patients during which they face many challenges. This first year represents a time of adaptation, in which family seems essential.