Patient participation in the clinical pathway-Nurses' perceptions of adults' involvement in haemodialysis

Aim: To develop knowledge of nurses' perceptions of participation for patients treated with haemodialysis and their next of kin. Design: A qualitative study with a hermeneutic approach. Methods: The data were collected in 2015 through focus groups with 13 nurses in Central Norway. Results: The nurses reported that patient participation ranging from non-involvement to shared decision-making was related to whether dialysis was initiated as acute or scheduled. The restrictions required in chronic haemodialysis limited participation. The next of kin were not involved. The nurses highlighted interventions on both the individual and system levels to strengthen participation. Conclusion: Dialysis units should develop strategies for participation related to individual needs and design treatment in cooperation with patients and their families, ensuring involvement early in the clinical pathway. Further research is needed on issues related to next of kin, including their desired level of involvement.