An ethnographic journey to uncover the culture of dialysis units

Ashwanden, Cordelia (2002) An ethnographic journey to uncover the culture of dialysis units. University of Southampton, School of Nursing and Midwifery, Doctoral Thesis , 192pp.


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A major challenge of the 21st century for the health-care professionals is to provide care for
the ever-expanding population of people with renal-failure. Patient numbers are rising and
specialist nurses, who are the pivotal factor in haemodialysis units, are becoming
increasingly scarce. In this context it has become essential to understand the dynamics and
functioning of haemodialysis units. The aim of this research project is to increase
understanding of the lives of patients and carers by uncovering the culture of haemodialysis

Ethnography, from the naturalistic paradigm, is a holistic study of culture, developed out of
classical philosophy. This study examines the entire social world of the dialysis unit. It
describes the ethnographic journey made over twenty-four months' research in two different
dialysis units. The participants were amongst patients and carers from these two units. The
fieldwork, which facilitated data collection, was based on a participatory process of
observation, interviews and participant feedback. These data were analysed into domains
and themes using Spradley's Research development sequence (1980) and the reflexive
process. Through the theme-based analysis used during the research and writing of this
ethnographic study an emergent theory of partnership in care became apparent. Such a
theory contributes to our understanding of the culture of the dialysis unit.

Uncovering the culture of dialysis units will not prevent the increase in numbers of people
needing Renal Replacement Therapy. It does, however, shed light on the condition of
living with renal failure and the nature of partnerships developed in the haemodialysis unit.
It is these partnerships between people, machines and the environment that sets the dialysis
unit apart in the hospital, giving it its own particular culture. Partnership means shared care
where patients and carers work towards mutual goals. The realisation of these common
goals leads towards the overall objective of better treatment outcomes.

Item Type: Thesis (Doctoral)
Subjects: H Social Sciences > HM Sociology
R Medicine > RC Internal medicine
R Medicine > RT Nursing
Divisions : University Structure - Pre August 2011 > Superseded (SONM)
ePrint ID: 50616
Accepted Date and Publication Date:
December 2002Made publicly available
Date Deposited: 27 Mar 2008
Last Modified: 27 Mar 2014 18:33

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