Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Nursing

Supervisor

Babenko-Mould, Yolanda

2nd Supervisor

Jackson, Kim

Co-Supervisor

Abstract

The number of Canadians being treated for kidney failure has more than tripled in the last 20 years, making hemodialysis (HD) a more common and expensive treatment option. Individuals having in-center HD require access to transportation to and from an HD center on average three days a week for a total of six trips. Therefore, access to transportation is a vital component for sustaining the health and well-being of this population. The purpose of this interpretive descriptive qualitative study was to explore how persons requiring in-center HD treatment explain the ways in which access to transportation for such treatment influences their overall health, using the World Health Organization’s definition of health. A purposive sample of eight individuals were recruited and each participated in an individual audio-recorded semi-structured interview. Using inductive analysis, three interrelated themes were identified:reliability, choice, and personal safety.The findings highlight that individuals using transportation services for HD experience the challenge of reliable services, this included: dependability of transportation services for HD treatment and connection to health, and variations in consistency and coordination of transportation. Financial impacts and asking for support from family and friends factored participants’ choicein using alternative modes of transportation when services were unreliable. Transportation services also impact the personal safety of persons on HD, as participants shared the need for resources for safer travel and behaviours reflecting need for driver education. The findings can serve to inform changes in practice, research, and policies that influence the health of this population.

Summary for Lay Audience

The number of Canadians being treated for kidney failure has more than tripled in the last 20 years, making hemodialysis (HD) a more common and expensive treatment option. Individuals having in-center HD require access to transportation to and from an HD center on average for six trips a week. Therefore, access to transportation is an important component for sustaining the health and well-being of this population. The purpose of this study was to explore how persons requiring in-center HD treatment explain the ways in which access to transportation for such treatment influences their overall health, using the World Health Organization’s definition of health. Findings identified three interrelated themes:reliability, choice, and personal safety.The findings highlight that individuals using transportation services for HD experience the challenge of reliable services, this included: dependability of transportation services for HD treatment and connection to health, and variations in consistency and coordination of transportation. Financial impacts and asking for support from family and friends factored into participants’ choiceforusing alternative modes of transportation when services were unreliable. Transportation services also impacted the personal safety of persons using HD, as participants shared the need for resources for safer travel and behaviours reflecting need for driver education. Overall, there needs to be improvement in access to transportation for HD treatment as it impacts the health of individuals requiring such treatment.

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