{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:38:42Z","timestamp":1765820322606,"version":"3.48.0"},"reference-count":18,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"crossref","award":["APP1106716"],"award-info":[{"award-number":["APP1106716"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"crossref","award":["72210455"],"award-info":[{"award-number":["72210455"]}],"id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,2,22]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the experiences of nephrologists on caring for patients undergoing in-centre haemodialysis during the COVID-19 pandemic in Latin America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Twenty-five semistructured interviews were conducted by Zoom videoconference in English and Spanish languages during 2020 until data saturation. Using thematic analysis, we conducted line-by-line coding to inductively identify themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>25 centres across nine countries in Latin America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Nephrologists (17 male and 8 female) were purposively sampled to include diverse demographic characteristics and clinical experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified five themes: shock and immediate mobilisation for preparedness (overwhelmed and distressed, expanding responsibilities to manage COVID-19 infection and united for workforce resilience); personal vulnerability (being infected with COVID-19 and fear of transmitting COVID-19 to family); infrastructural susceptibility of dialysis units (lacking resources and facilities for quarantine, struggling to prevent cross-contamination, and depletion of personal protective equipment and cleaning supplies); helplessness and moral distress (being forced to ration life-sustaining equipment and care, being concerned about delayed and shortened dialysis sessions, patient hesitancy to attend to dialysis sessions, being grieved by socioeconomic disparities, deterioration of patients with COVID-19, harms of isolation and inability to provide kidney replacement therapy); and fostering innovative delivery of care (expanding use of telehealth, increasing uptake of PD and shifting focus on preventing syndemics).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nephrologists felt personally and professionally vulnerable and reported feeling helpless and morally distressed because they doubted their capacity to provide safe care for patients undergoing dialysis. Better availability and mobilisation of resources and capacities to adapt models of care, including telehealth and home-based dialysis, are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-062321","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T10:00:56Z","timestamp":1683885656000},"page":"e062321","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Nephrologists\u2019 perspectives on the impact of COVID-19 on caring for patients undergoing dialysis in Latin America: a qualitative study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5058-6239","authenticated-orcid":false,"given":"Andrea","family":"Matus Gonzalez","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"}]},{"given":"Eduardo","family":"Lorca","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad de Chile, Santiago, Chile"}]},{"given":"Sebastian","family":"Cabrera","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad de Chile, Santiago, Chile"}]},{"given":"Alejandra","family":"Hernandez","sequence":"additional","affiliation":[{"name":"CESFAM Santa Amalia, Corporaci\u00f3n Municipal de la Florida, Santiago, Chile"}]},{"given":"Carlos","family":"Z\u00fa\u00f1iga-SM","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Cat\u00f3lica de la Sant\u00edsima Concepci\u00f3n, Concepci\u00f3n, Chile"},{"name":"Facultad de Medicina, Universidad de Concepci\u00f3n, Concepci\u00f3n, Chile"}]},{"given":"Laura","family":"Sola","sequence":"additional","affiliation":[{"name":"Centro de Hemodi\u00e1lisis Cr\u00f3nica, Centro de Asistencia del Sindicato Medico del Uruguay- Instituci\u00f3n de Asistencia Medica Privada de Profesionales sin fines de lucro (CASMU-IAMPP), Montevideo, Uruguay"}]},{"given":"Luis","family":"Michea","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad de Chile, Santiago, Chile"}]},{"given":"Alejandro","family":"Ferreiro Fuentes","sequence":"additional","affiliation":[{"name":"Centro de Nefrolog\u00eda, Facultad de Medicina, Universidad de la Rep\u00fablica, Montevideo, Uruguay"}]},{"given":"Lilia","family":"Cervantes","sequence":"additional","affiliation":[{"name":"Department of Medicine and Office of Research, Denver Health, Denver, Colorado, USA"}]},{"given":"Magdalena","family":"Madero","sequence":"additional","affiliation":[{"name":"Departamento de Nefrologia, Instituto Nacional de Cardiolog\u00eda, Ciudad de M\u00e9xico, ciudad de Mexico (CDMX), M\u00e9xico"}]},{"given":"Armando","family":"Teixeira-Pinto","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"}]},{"given":"Germaine","family":"Wong","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"}]},{"given":"Jonathan","family":"Craig","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Faculty of Medicine Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8973-9538","authenticated-orcid":false,"given":"Allison","family":"Jaure","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Centre for Kidney 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