PATIENT-PROFESSIONAL INTERACTIONS PERCEIVED BY PERITONEAL DIALYSIS PATIENTS: A SYSTEMATIC REVIEW OF QUALITATIVE STUDIES

While Peritoneal dialysis (PD) is a burdensome treatment for end-stage kidney disease (ESKD), current dialysis literature is dominated by haemodialysis-specific patient experiences. More knowledge about interactions between health professionals and PD patients from the patients’ perspective can improve the quality of care for PD patients. The first author, a former PD patient with a background in psychology and experience in health service delivery, led the design and implementation of this qualitative systematic review. This study synthesized existing research on how PD patients perceive their interactions with health professionals. 

This review included patients aged eighteen years and older who are on continuous ambulatory or automated PD, excluding assisted PD patients. Qualitative studies published in English between 2010 and 2024 were included. APA PsycINFO, CINAHL Complete, Embase, and MEDLINE were searched on January 1, 2025. The quality of the studies was assessed using the Quality Assessment for Diverse Studies (QuADS) tool. Using Braun and Clarke’s reflexive approach, the first author conducted an inductive thematic analysis on participant quotes extracted from the included articles. After independently extracting and familiarizing herself with the data, she generated initial latent codes. These codes were synthesized into themes, which were refined to reflect the core concepts and patterns identified. 

Twenty studies with 514 patients were reviewed, covering clinical aspects, psychosocial aspects, and the overall experience of PD patients. The six themes identified included key areas of poor care delivery as well as opportunities for positive interaction: information deficits and communication challenges (inadequate patient education, authoritarian communication style and limited shared decision-making), missed opportunities for connection (lack of emotional rapport and poor interviewing technique), gaps in clinical care (deficient monitoring and inconsistent team communication), effective communication and transparency (promoting health literacy and clear communication, and facilitating open discussion and shared decision-making), interpersonal skills (building rapport and fostering trust; demonstrating humanity and compassion towards patients), and patient-centered approach (prioritizing patient needs and believing in patients and empowering them). 

Peritoneal dialysis patients perceive that health literacy and clear communication, as well as open discussion and shared decision-making during their interaction with health professionals, are as important as the quality of clinical care they receive. While these communication elements have long been studied in the context of treatment adherence, more research is needed to explore how relational bonds, humanity and compassion support PD patients in self-managing their chronic illness. This is particularly relevant in aligning with the shift towards patient and relationship-centered care, emphasising the prioritization of patient needs, trust and empowerment. The findings of this study can be incorporated into patient-reported experience measures, training for the multidisciplinary renal team, and pre-dialysis education information for patients.