Perceived barriers contributing to non-compliance among dialysis patients at a private tertiary care hospital Karachi, Pakistan : a qualitative exploratory study

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)


School of Nursing and Midwifery, Pakistan


Perceived Barriers Contributing to Non-Compliance Among Dialysis Patients at a Private Tertiary Care Hospital, Karachi, Pakistan: A Qualitative Exploratory Study. Background: Chronic Kidney Disease (CKD) has the most excruciating effects on the quality of life and the life expectancy of the patients. CKD is also known as irreversible renal failure and it has six stages. ESRD is the last of and sixth stage of the chronic renal disease (G. J. Kim, Je, Kim, & Lee, 2016). Hemodialysis is the primary mode of treatment for patients with CKD or ESRD, and compliance to this treatment regimen in dialysis patients is very important. One of the major reasons behind increased morbidity and mortality is non-compliance; however, other causes are yet to be explored. Non-compliance has been addressed in other contexts but not in Pakistan, therefore, addressing non-compliance in hemodialysis patients is significant. Purpose: The purpose of the study was to explore the perceived barriers of non-compliant behaviors among dialysis patients at a private tertiary care hospital in Karachi, Pakistan. The study helped in exploring the hindering factors of non-compliant behaviors among hemodialysis patients. Methodology: A qualitative descriptive exploratory design was employed to explore patients' perceptions of non-compliance. The study setting was the outpatient hemodialysis unit at a private tertiary care hospital, Karachi, Pakistan. The targeted population was the patients on maintenance hemodialysis who came as outpatients for their scheduled dialysis. Using a purposive sampling, a total of nine participants were recruited for the study. A semi-structure guide was used to collect the data. The interviews were voice recorded and were transcribed verbatim. Findings: The analysis of the in-depth interviews helps the researcher to extract two main themes and eight categories. The eight categories were derived from several sub-categories. The main themes "perceived barriers" and "factors leading to non-compliance" are based on the primary research questions. The findings of the current study revealed that the subcategories; psychosocial, value belief, health care professionals' relationship with patients are the the patients' perceived barriers that were contributing to noncompliance. Whereas, factors leading to noncompliance included physiological factors, fluid restriction, and dietary restriction. Conclusion: It is concluded that patients' understanding of compliance to the hemodialysis regimen is affected by the perceived barriers and the physiological and behavioral factors.

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