{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:27:08Z","timestamp":1786598828479,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To map the care trajectory of patients with diabetic kidney disease from disease progression to maintenance haemodialysis and identify key risks and nursing care gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive qualitative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individual semi\u2010structured interviews were conducted among patients with diabetic kidney disease undergoing maintenance haemodialysis. Data were analysed using qualitative content analysis and synthesised into a visual patient journey map.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen participants were included. The care trajectory comprised four stages: insidious progression, acute deterioration, dialysis initiation and dialysis maintenance. Thirty subcategories were identified across three domains: tasks, challenges and emotions. The journey map highlighted three key risks shaping patients' experiences across the disease trajectory: inadequate recognition of disease risk and delayed early management; difficulties in dialysis decision\u2010making; and difficulties in reorganising everyday life alongside an accumulating treatment burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with diabetic kidney disease experience evolving and cumulative multidimensional challenges as they progress to maintenance haemodialysis. Targeted nursing interventions are needed to improve patients' experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Nursing care should strengthen early risk perception and self\u2010management, support shared decision\u2010making about dialysis, facilitate adaptation to dialysis\u2010related lifestyle changes and reduce the cumulative burden of long\u2010term treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patients helped refine the interview guide and provided feedback on the journey map.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70510","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T04:32:18Z","timestamp":1786595538000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Experiences of Patients With Diabetic Kidney Disease on Maintenance Haemodialysis: A Qualitative Study Using a Journey Map"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0344-3197","authenticated-orcid":false,"given":"Kai","family":"Di","sequence":"first","affiliation":[{"name":"School of Nursing and Rehabilitation Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8099-9659","authenticated-orcid":false,"given":"Yuan","family":"Sheng","sequence":"additional","affiliation":[{"name":"School of Nursing and Rehabilitation Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing and Rehabilitation Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lunping","family":"Pan","sequence":"additional","affiliation":[{"name":"School of Nursing and Rehabilitation Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[{"name":"PICC Clinic Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deshan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010025\u201002829\u2010z"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023\u2010022\u201002270\u20104"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14196943"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2021.10.008"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.08.012"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare14010056"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S354549"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.18808"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882\u2010025\u201003952\u20104"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2022.02.017"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12577"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2003.10.001"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.01.034"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2017.07.008"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13121409"},{"key":"e_1_2_14_18_1","doi-asserted-by":"crossref","DOI":"10.1016\/0147-1767(85)90062-8","volume-title":"Naturalistic Inquiry","author":"Lincoln Y. 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