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Jennifer Wong, MASc

Jennifer Wong, MASc, is the Senior Analyst, The Centre for Global eHealth Innovation, University Health Network, and the Department of Mechanical and Industrial Engineering, Faculty of Engineering, University of Toronto, Toronto, Canada.

Joan Eakin, PhD

Joan Eakin, PhD, is a Professor, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Paul Migram, PhD, PEng

Paul Migram, PhD, PEng, is a Professor, Department of Mechanical and Industrial Engineering, Faculty of Engineering, and the Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto,Ontario, Canada.

Joseph A. Cafazzo, PhD, PEng

Joseph A. Cafazzo, PhD, PEng, Director, The Centre for Global eHealth Innovation, University Health Network, Toronto, Ontario, Canada.

Nancy V.D. Halifax, PhD

Nancy V.D. Halifax, PhD, is an Assistant Professor, The Centre for Global eHealth Innovation, University Health Network, Toronto, Ontario, Canada.

Christopher T. Chan, MD, FRCPC

Christopher T. Chan, MD, FRCPC, holds the R. Fraser Elliott Chair in Home Dialysis, Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.

Purpose: The purpose of this study was to explore patient training experiences related to the selfadministration of hemodialysis at home. Researchers used a qualitative study using semi-structured interviews and a focus group. The setting was a hospital-based patient education program in Toronto, Ontario, Canada. Qualitative interviews and focus group study were conducted with 23 patients (who had end stage renal disease) and caregivers who have participated in Toronto General Hospital’s Nocturnal Home Hemodialysis training program to learn how to operate a hemodialysis machine and to administer their own treatments at home without the supervision of clinicians.

Results: Experience as a trainee in the Nocturnal Home Hemodialysis program was framed by 5 diverse themes: patients’ perceptions of anxiety, peer support, clinician empathy and understanding, learning while ill, and the compatibility of learning preferences with training practices employed.

Conclusions: The study revealed the complexity of the patients’ experience with being prepared for a self-treatment regime at home. Although it was anticipated that the most important barrier to patient preparation would be the challenges of managing complex medical technology, psychosocial dimensions of their experiences were the primary factors impacting on the patients’ ability to learn and to take on self-care responsibility. If the trend of patient self-treatment at home continues to increase, it is important for clinician educators to be attentive to self-treatment as a socially situated activity.