Health Sciences Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences – Health Science Department

First Advisor

Kamilah Thomas-Purcell

Date of original Performance / Presentation

January 2024

Publication Date / Copyright Date

1-1-2024

Abstract

Telehealth, the use of telecommunication tools to facilitate access to healthcare services, has notably surged since the emergence of the COVID-19 pandemic. In nephrology, telehealth has become crucial in delivering care to dialysis patients, especially after the removal of previous restrictions that limited the application of telehealth in dialysis settings. The objective of this dissertation study is to examine the perceptions of telehealth held by dialysis patients and nephrologists and to understand the decision-making process, challenges faced, and the adaptation strategies employed when using telehealth in dialysis settings. The research employed a case study design, defining the case as the telehealth use process for dialysis care within dialysis centers in Washington State. A purposeful sampling strategy was used to select dialysis patients and nephrologists who had experienced telehealth in dialysis care. The participants were 12 dialysis patients and six nephrologists from two dialysis centers in Washington State. Data collection involved interviews with nephrologists and dialysis patients, direct observation of telehealth use during dialysis care, and analysis of documents from dialysis companies. Data analysis and interpretation were conducted through coding, categorization, and thematic analysis. Six themes emerged from the data, including telehealth acceptance, telehealth rejection, the nephrologist’s role in decision-making, challenges with telehealth connectivity affecting dialysis visits, the unsupportive role of dialysis companies, and adaptation to technological challenges. The insights gained from this study can contribute to the advancement of education, research, practice, and public policy related to telehealth implementation for dialysis patients.

Disciplines

Medicine and Health Sciences

Keywords

Case study research; COVID-19; Dialysis; Qualitative design; Telehealth

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