The comfort experiences and needs of maintenance hemodialysis patients: a qualitative study to inform person-centred health services

Maintenance hemodialysis poses a substantial public health burden. Despite its life-sustaining benefits, patients experience discomfort related to disease and hemodialysis. Understanding their discomfort, comfort experiences, and comfort needs is necessary to inform person-centred care. However, how patients experience and interpret discomfort and comfort remains insufficiently understood in the Chinese sociocultural context. This study aimed to explore how Chinese maintenance hemodialysis patients experience and interpret discomfort and comfort and to identify their comfort needs. A qualitative study using interpretative phenomenological analysis was conducted. Twenty-one maintenance hemodialysis patients were recruited from a national public hospital in China. In-depth semi-structured interviews were conducted between January and May 2025. Data were analysed inductively and iteratively using the six steps of interpretative phenomenological analysis. NVivo 15 was used to organize the data. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Three themes were identified:“putting up with the burdens of disease and hemodialysis,” “experiencing respite in life with hemodialysis,” and “seeking a decent life with hemodialysis.” Participants’ discomfort encompassed the aggravating interactions among physical symptoms, the overwhelming psychological crises, the compromised social support system, and the disturbing healthcare environment. Their comfort experiences encompassed early hemodialysis for earlier relief, family support, and fellow patients huddling for warmth. No participant described the healthcare environment as a source of comfort. Their comfort needs included freedom from physical and psychological discomfort, rebuilding life meaning, a life-oriented healthcare environment, and access to disease-related information. Chinese maintenance hemodialysis patients experienced multidimensional discomfort as burdens of everyday life with disease and hemodialysis. They found comfort through treatment and support from others, while their comfort needs reflected a desire to live with dignity, meaning, and some control over daily life. Cultural values and beliefs within the Chinese sociocultural context may shape how patients experience and interpret discomfort and comfort, as well as their comfort needs. These findings highlight the need for culturally adapted, person-centred care to alleviate discomfort, enhance comfort, and address patients’ comfort needs. Practical suggestions were also proposed for nurses to tailor care to patients’ experiences and needs within this sociocultural context.