Initiation into a dialysis-dependent life: an examination of rites of passage

The purpose of this article is to explore the conceptual and empirical application of the rites of passage model in contemporary health care for those who are dialysis dependent. This study used a collective case study design and narrative methodology. A purposive sample yielded 10 participants who were receiving dialysis. Prolonged observation and immersion in the culture of dialysis dependency occurred in the settings of the participants' home and renal units in Queensland, Australia. In-depth interviews and narrative analysis were used. The criteria of reflexivity, voice, and verisimilitude established the rigor of the study. The findings illuminated the three stages of rites of passage (ROP), separation, liminality, and reincorporation, with each stage evident in the participants' stories. Commencing dialysis is an initiation that delineates the transition from one social status to another. It is argued that there is a metaphoric usefulness of the application of the ROP model that might influence the quality of care to dialysis initiates.