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Perspectives on clinical use of bioimpedance in hemodialysis: focus group interviews with renal care professionals.
Department of Medical Sciences, University Hospital, Uppsala, Sweden.ORCID-id: 0000-0003-2408-0087
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID-id: 0000-0003-1289-9896
Department of Medical Sciences, University Hospital, Uppsala, Sweden.
2018 (Engelska)Ingår i: BMC Nephrology, ISSN 1471-2369, E-ISSN 1471-2369, Vol. 19, nr 1, artikel-id 121Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals' perceived barriers and facilitators for use of bioimpedance in clinical practice.

METHODS: Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device. The participants were connected to each other and a moderator via equipment for telemedicine and the sessions were recorded. The interviews were semi-structured, focusing on the participants' perceptions of use of bioimpedance in clinical practice. Thematic content analysis was performed in consecutive steps, and data were extracted by employing an inductive, interactive, comparative process.

RESULTS: Several barriers and facilitators to the use of bioimpedance in clinical practice were identified, and a multilevel approach to examining barriers and incentives for change was found to be applicable to the ideas and categories that arose from the data. The determinants were categorized on five levels, and the different themes of the levels illustrated with quotations from the focus groups participants.

CONCLUSIONS: Determinants for use of bioimpedance were identified on five levels: 1) the innovation itself, 2) the individual professional, 3) the patient, 4) the social context and 5) the organizational context. Barriers were identified in the areas of credibility, awareness, knowledge, self-efficacy, care processes, organizational structures and regulations. Facilitators were identified in the areas of the innovation's attractiveness, advantages in practice, and collaboration. Motivation, team processes and organizational capacities appeared as both barriers and facilitators.

Ort, förlag, år, upplaga, sidor
2018. Vol. 19, nr 1, artikel-id 121
Nyckelord [en]
Barriers, Bioimpedance, Dry weight, Facilitators, Focus groups, Renal dialysis
Nationell ämneskategori
Urologi och njurmedicin Omvårdnad
Identifikatorer
URN: urn:nbn:se:hig:diva-26640DOI: 10.1186/s12882-018-0907-4ISI: 000433236500004PubMedID: 29792174Scopus ID: 2-s2.0-85047621661OAI: oai:DiVA.org:hig-26640DiVA, id: diva2:1210594
Tillgänglig från: 2018-05-29 Skapad: 2018-05-29 Senast uppdaterad: 2020-01-29Bibliografiskt granskad

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