Challenges Faced by Dialysis Unit Staff During COVID-19 Times: A Qualitative Study

  1. P. Ravi Kumar
  2. Amol Dongre

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Abstract

Background: The Coronavirus has caused an epidemic affecting the whole world for the last two years and has been spreading steadily. The hemodialysis patients are at high risk because of their lowered immunity status. The dialysis staff is also at higher risk of contracting COVID-19 as these patients come for twice/thrice weekly treatment sessions. Objectives: This study was done to study the hardships and problems afflicting the dialysis staff during the infections caused by COVID-19 in a rural hemodialysis unit. Methods: This study setting was the hemodialysis unit located in a rural hospital in Pondicherry, India. Free listing and pile sorting were done to study the structure and salient problems as felt in the cognitive domain by the dialysis team. Smith's S value was calculated for a free listing. Multidimensional scaling and cluster analysis were conducted to do pile sorting of data. Data were analyzed using Anthropac 4.983/X. Group interviews were carried out to get in-depth information and validate the findings obtained from the free list and pile sorting exercise. Results: Twelve salient items were obtained from the free list. Three broad domains emerged: the absence of personal safety, shortage of personal safety equipment, and presence of logistical and operational problems. Surprisingly, RT-PCR testing was not perceived to be of importance for them. Conclusions: Accepting the true feelings, fears, and needs of the dialysis staff, helping to tackle the impediments to personal safety, and the lack of personal safety equipment in a dialysis unit during COVID-19 outbreak are vital in ensuring personal safety and improving working dynamics.

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  1. Version published to 10.5812/numonthly-121133
  2. ScreenIT

    SciScore for 10.1101/2020.10.20.20215715: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: The study procedure was sequential in nature, where free list directed pile sort, which in turn offered direction to focus group, ultimately contributing the validity of the findings. The study was rapid and findings in visual format were easy to understand and evoke discussion among the participants. The findings were useful in understanding the dynamics for decision-making and action taking. Data saturation was achieved, adding more weightage to this study. There is scope for transferability of these findings to other departments in a hospital and various institutions in the surrounding areas of Pondicherry, all over India and elsewhere as such. The COREQ guidance (COnsolidated criteria for Reporting Qualitative research) as shown in Appendage 2 was applied while drafting this paper which added to the rigor, clarity and transparency of this study.24,25,26 However, the limitations of the present study should be kept in mind. The background of researcher and personal biases of the researcher could not be eliminated fully. Another limitation was that we did not further analyze the subgroups by separating the dialysis nurses, dialysis technicians and the doctors as our aim was to see the whole dialysis unit as one cohesive and patient centric group. Despite all the challenges faced by the dialysis staff, the patients also have their challenges but yet they demonstrate remarkable resilience.27 It would be worthwhile to get away from a traditional probl...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.10.20.20215715v1 on medRxiv