# Living with haemodialysis in Sri Lanka: a qualitative study on patient adaptation and care perceptions

## TL;DR

This study explores how patients in Sri Lanka adapt to life with haemodialysis and their perceptions of care, highlighting the need for person-centred approaches to improve their quality of life.

## Contribution

The study provides novel insights into patient experiences of haemodialysis care in Sri Lanka, emphasizing the importance of person-centred care in low- to middle-income settings.

## Key findings

- Patients face significant physical and psychological burdens from haemodialysis, impacting their daily lives.
- Coping mechanisms, including spirituality and family support, help patients adapt to their disrupted life trajectories.
- Participants emphasized the need for accessible, compassionate, and high-quality haemodialysis care.

## Abstract

The increasing prevalence of individuals undergoing haemodialysis (HD) compels the necessity of person-centred care to minimise treatment-related complications and improve the quality of life. Although the person-centred approach has been widely discussed, it remains underutilised in HD care, particularly in low- to middle-income countries. Understanding how patients perceive their care is crucial for developing tailored interventions and achieving desirable health outcomes. Therefore, this study was aimed to explore patients’ experiences of HD care in three selected government hospital dialysis units in Colombo District, Sri Lanka.

One-to-one, semi-structured interviews were conducted with a purposive sample of twelve participants undergoing HD for more than six consecutive months and receiving at least one dialysis session per week. Interviews were conducted from April to December 2022 until data saturation was reached. All interviews were digitally recorded, transcribed verbatim and analysed using the qualitative content analysis proposed by Graneheim and Lundman.

An overarching theme, ‘Adapting to a Disrupted Life Trajectory’ with four categories emerged: Burden of living with HD, Physical and psychological consequences of treatment, Coping and adjustment mechanisms, Healthcare system and service experiences. Daily life was often a burden for the participants due to physical and psychological challenges, numerous life restrictions and self-care burden. Despite these altered life routines, patients adapted coping mechanisms to regain a sense of control and maintain continuity of their treatment. Stigma associated with the terminal illness, famiy dynamics, and internal coping through spirituality shaped unique patient adaptation to the illness experience. Participants expressed a need for accessible HD care that is high in quality, safe, and delivered with compassion.

A person-centred approach, including goals of care conversations, would help to address patients’ concerns related to the multifaceted burden of HD treatment. Strengthening a well-coordinated, multidisciplinary team including nephrology, palliative care, and community-based services is essential to meet patients’ complex needs and provide specialist support across physical, psychological, social, and spiritual domains during the illness trajectory in a more holistic and timely manner.

The online version contains supplementary material available at 10.1186/s12882-025-04728-6.