What facilitated the successful evacuations of patients on dialysis after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident? A qualitative analysis of facility staff experiences and perspectives

This study aimed to assess the impact of the 2011 Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident on dialysis management in the affected areas. Although many challenges faced by dialysis facilities after large-scale complex disasters have been previously reported, the first-hand experiences of stakeholders involved in these facilities have not been appraised. To address this gap, we conducted interviews with 22 facility staff in the Hamadori area of Fukushima Prefecture. The semi-structured interview questions encompassed topics such as the evacuation and transport of patients undergoing dialysis, dialysis treatment during major disasters, and the necessary disaster education and preventive measures for future scenarios. Thematic analysis was employed to assess the interview data and identify recurring themes and patterns. Four main themes were identified: physical and mental burden during evacuation and transport, patient damage due to dialysis therapy disasters before wide-area evacuation, the importance of disaster education, and the importance of disaster response measures. These themes emerged from the appraisal of 12 sub-themes. The results revealed several critical needs: significant physical assistance during patient transportation, increased burden on patients, the importance of education and manual development, and the necessity of strengthening collaboration with other facilities. The identified issues and proposed solutions in this study could contribute to the development of more robust disaster response strategies for dialysis care in the future.