{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T20:48:38Z","timestamp":1768250918597,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T00:00:00Z","timestamp":1390348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Missed hemodialysis treatments lead to increased morbidity and mortality in the end\u2010stage renal disease population. Little is known about why patients have difficulty attending their scheduled in\u2010center dialysis treatments. Semistructured interviews with 15 adherent and 15 nonadherent hemodialysis patients were conducted to determine patients' attitudes about dialysis, health beliefs and risk perception regarding missed treatments, barriers and facilitators to hemodialysis attendance, and recommendations to improve the system to facilitate dialysis attendance. Average time on dialysis was 2.5 years for the nonadherent group and 7.3 years in the adherent group. In both groups, patients felt that dialysis is life\u2010saving and a necessity. A substantial number of patients in both groups understood that missing hemodialysis treatments is dangerous and several patients could clearly communicate the risk of skipping. The most common barriers to hemodialysis were inadequate or unreliable transportation (mentioned in both groups) and a lack of motivation to get to dialysis or that dialysis is not a priority (typically mentioned by the nonadherent group). Facilitators to hemodialysis attendance included explanations from the health care team regarding the risk of skipping and relationships with other dialysis patients. Patient recommendations to improve dialysis attendance included continued education about the risk of poor attendance and more accessible transportation. Patients did not feel that home dialysis would improve adherence. Hemodialysis patients must adhere to a complex and burdensome regimen. Through the elucidation of barriers and facilitators to hemodialysis attendance and through specific patient recommendations, at least three interventions may be further investigated to improve hemodialysis attendance: Improvement of the transportation system, education and supportive encouragement from the health care team, and peer support mentorship.<\/jats:p>","DOI":"10.1111\/hdi.12139","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T05:30:59Z","timestamp":1390368659000},"page":"364-373","source":"Crossref","is-referenced-by-count":27,"title":["In\u2010center hemodialysis attendance: Patient perceptions of risks, barriers, and recommendations"],"prefix":"10.1111","volume":"18","author":[{"given":"Kara B.","family":"Chenitz","sequence":"first","affiliation":[{"name":"Renal, Electrolyte and Hypertension Division Department of Medicine Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Fernando","sequence":"additional","affiliation":[{"name":"School of Engineering and Applied Sciences at the The University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy A.","family":"Shea","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"US Renal Data System.USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End\u2010Stage Renal Disease in the United States. 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