Patients' Perspectives on Health-Related Social Needs and Recommendations for Interventions: A Qualitative Study

Document Type


Publication Date



MaineHealth Institute for Research

Journal Title

American journal of kidney diseases : the official journal of the National Kidney Foundation


RATIONALE & OBJECTIVE: People with low socioeconomic status are disproportionately affected by kidney failure, and their adverse outcomes may stem from unmet health-related social needs. This study explored hemodialysis patient perspectives on health-related social needs and recommendations for intervention. STUDY DESIGN: Qualitative study using semi-structured interviews. SETTINGS & PARTICIPANTS: Thirty-two people with low socioeconomic status receiving hemodialysis at three hemodialysis facilities in Austin, Texas. ANALYTICAL APPROACH: Interviews were analyzed for themes and subthemes using the constant comparative method. RESULTS: Seven themes and 21 subthemes (in parentheses) were identified: 1) kidney failure was unexpected (never thought it would happen to me, do not understand dialysis); 2) providers fail patients (doctors did not act, doctors do not care); 3) dialysis is detrimental (life is not the same, dialysis is all you do, dialysis causes emotional distress, dialysis makes you feel sick); 4) powerlessness (dependent on others, cannot do anything about my situation); 5) financial resource strain (dialysis makes you poor and keeps you poor, disability checks are not enough, food programs exist but are inconsistent, eat whatever food is available, not enough affordable housing, unstable housing affects health and wellbeing); 6) motivation to keep going (faith, support system, will to live); and 7) interventions should promote self-efficacy (navigation of community resources, support groups). LIMITATIONS: Limited quantitative data such as on dialysis vintage. Limited geographic representation. CONCLUSIONS: Dialysis exacerbates financial resource strain, and health-related social needs exacerbate dialysis-related stress. Participants made recommendations to address social needs with an emphasis on increasing support and community resources for this population.