Transformations: a phenomenological investigation into the life-world of home haemodialysis

With a growth in home-care, and increased funding for dialysis, there is a need for the field of Social Work to understand the life-world of people who experience home haemodialysis technology (HDDT). Given little research has focussed on the lived-experiences of this population (Nagle, 1995), an exploratory qualitative study was employed (Strauss & Corbin, 1998). The study investigated the embodied life-world experiences of this population using phenomenological methods (Kvale, 1996; van Manen, 1997). The data was collected and analyzed in terms of the four basic phenomenological categories of lived-time, lived-body, lived-spatiality, lived-relations with others and self (van Manen, 1997). A purposive sample of four was selected, and interviewed using semi-structured interviews, with each participant experiencing various lengths of HHDT. The findings revealed that their life-world had been transformed by their experience of HHDT. In particular, it was documented how participants' adoption of medical practice and discourse has impacted the lived-body, suggesting a need to adopt a plain language or holistic medical discourse practice approach for communication with patients which supports bodily-integrity and sovereignty. Additional findings centered on the incorporation of HHDT into the family unit, and how HHDT may present a health care access barrier to those without homes. Moreover, aspects of the transformation of the home into a hospital were highlighted. Finally, it is suggested that social assessment should consider the patient and family's experience of the dialysis machine.