Determinants Of Quality of Hemodialysis Services in Selected County Dialysis Centers in Nyanza Region, Kenya

Doreen Nyabaro BscN1, Grace Githemo PhD RN1, & Lister Onsongo PhD2
1Department of Medical-Surgical Nursing, Kenyatta University, Nairobi, Kenya
2Community Health and Reproductive Health Nursing Department, School of Nursing, Kenyatta University, Nairobi, Kenya
DOI – http://doi.org/10.37502/IJSMR.2023.6921

Abstract

Background: Hemodialysis is a common management intervention in chronic kidney and End-Stage Renal Disease patients. Despite the increase in utilization of maintenance hemodialysis in low and medium-income countries, there needs to be more efforts to assess the quality of hemodialysis services.

Objective: To evaluate the quality of hemodialysis services at selected county dialysis centres.

Methodology: A cross-sectional descriptive study was used. Proportionate sampling was used with a sample size of 118 patients on hemodialysis. Chi squares test was used to determine the association between variables while binary logistic regression analysis was used to determine predictors of quality hemodialysis services.

Results: Fifty-six percent of the participants perceived the quality of hemodialysis services as good. Gender, education level, co-morbidities, admission due to side effects, social support, waiting time, education before dialysis session, and satisfaction with care were associated with the quality of hemodialysis services. Moreover, being male (AOR =3.75, 95%CI: 1.11 – 12.64, p =0.033), having secondary level education (AOR =2.31, 95%CI: 1.41 – 4.97, p =0.046), having been admitted due to side effects since the beginning of hemodialysis sessions (AOR =0.22, 95%CI:0.15 – 0.86, p<0.001), having received social support from family and friends (AOR =11.49, 95%CI: 1.79 -73.95, p =0.010) and not waiting longer to be allocated a H.D. (AOR = 0.21, 95%CI: 0.05 – 0.93, p =0.041) as predictors of quality of hemodialysis services:

Conclusion and recommendation: The quality of hemodialysis services in selected centres is slightly above average. Increased health education, training more staff on the needs of patients, and reviewing appointment period based on the number of machines available is essential to improve the quality of hemodialysis services.

Keywords: Determinants, Chronic Kidney Disease, Hemodialysis, Quality

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