This exploratory qualitative study examined how adults receiving haemodialysis at the Tamale Teaching Hospital in Northern Ghana perceive the quality of nursing care. Fifteen patients with at least six months on dialysis were purposively selected and interviewed. Using Braun and Clarke’s reflective thematic analysis, researchers identified two primary themes: respect for patient preferences and physical comfort, each with three subthemes. Participants emphasised involvement in decision-making, dignity and autonomy, culturally sensitive care, effective pain control, assistance with daily activities, and a clean environment. The study highlights interpersonal and system-level factors that shape perceived quality and offers context-appropriate recommendations to strengthen patient-centered dialysis care in resource-constrained settings.
End-stage kidney disease (ESKD) imposes considerable physical and psychosocial burdens on patients, and haemodialysis remains the predominant renal replacement therapy globally. In resource-limited settings, the capacity of nursing staff and the state of dialysis infrastructure influence not only clinical outcomes but also patients’ experiences and satisfaction. The study frames quality nursing care as two complementary dimensions: interpersonal nursing behaviours (communication, empathy, respect, responsiveness) and structural or system-level influences (staffing, equipment, infrastructure). The research addresses a gap in qualitative evidence from sub-Saharan Africa on how adults undergoing HD perceive nursing care within constrained dialysis services.
The study aimed to explore perceptions of quality nursing care among adults receiving haemodialysis at the Tamale Teaching Hospital, the only public referral dialysis centre serving five northern regions of Ghana.
An exploratory descriptive qualitative design, grounded in an interpretivist paradigm, was employed to generate in-depth understanding where limited prior evidence exists. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) to support methodological transparency.
The research setting was the dialysis unit at Tamale Teaching Hospital, identified as the sole public referral HD centre in northern Ghana. The facility services a large catchment area where demand exceeds capacity. Fifteen adult patients who had been receiving dialysis for at least six months were purposively selected to participate, ensuring informed perspective on ongoing treatment experiences.
Data were collected via semi-structured interviews that were audio-recorded and transcribed verbatim. Thematic analysis followed Braun and Clarke’s reflective approach, enabling identification and interpretation of patterns across participants’ narratives. The analysis foregrounded participants’ own accounts of what constituted quality nursing care in their context.
One principal theme—respect for patient preferences—captured how interpersonal aspects of nursing care shaped patients’ perceptions. Subthemes included:
Involvement in decision-making: Participants highlighted the importance of being included in decisions about their care and treatment processes, noting that involvement improved their confidence and adherence.
Maintenance of dignity and respect for autonomy: Patients valued behaviours that preserved dignity during procedures and respected their choices; such actions were central to perceptions of quality.
Culturally sensitive care: Respondents emphasised the need for communication and education in simple local language and culturally responsive approaches, which foster trust and understanding between nurses and patients.
The second major theme—physical comfort—reflected practical aspects of care that directly affected patients’ comfort during and after dialysis. Subthemes included:
Effective pain management: Procedural pain, cramps, and post-dialysis discomfort were common concerns; participants stressed routine assessment and timely management of pain as essential to quality care.
Timely assistance with activities of daily living: Help with positioning, mobility, and other practical needs during dialysis influenced patients’ experiences and sense of safety.
Clean hospital environment: A hygienic and orderly dialysis environment was viewed as a component of comfort and safety, reinforcing trust in the care team.
Participants’ perceptions were shaped by broader health-system constraints described in the study. Key structural challenges reported include limited dialysis machines, frequent equipment breakdowns, unreliable water supply, staff shortages, overcrowding, and workflow inefficiencies that increased waiting times. These systemic issues constrained nurses’ capacity to deliver timely, individualized, and dignified care despite nurses’ interpersonal efforts.
The study concludes that improving perceived quality of nursing care for adults on haemodialysis in this resource-constrained setting requires interventions at both the interpersonal and structural levels. Recommendations arising from participants’ accounts include:
Nurse-led patient education delivered in simple local language to support understanding and involvement in care.
Routine pain assessment and prompt management of procedural pain and cramps during dialysis sessions.
Preservation of patient privacy and dignity during procedures and communication that reflects compassionate, culturally sensitive care.
Organisational improvements to address workflow inefficiencies, reduce waiting times, and strengthen dialysis resources (equipment, water supply, staffing) to enable consistent delivery of quality care.
The authors emphasise that context-appropriate strategies combining soft-skill training for staff (compassionate communication and cultural sensitivity) with investments in dialysis centre capacity are necessary to enhance treatment experiences, satisfaction, and overall quality of care in similar resource-limited settings.
Note: All details presented here are derived from the reported study. The source indicates data availability within the paper and that the research was conducted and reported according to COREQ; specific procedural details, participant quotations, and full methodological particulars are contained in the original article.