Mental Health World Conference 2026

Abstract

Background:
Young and middle aged patients receiving maintenance haemodialysis (MHD) face substantial biopsychosocial challenges across the illness trajectory. Patient journey mapping can visualise behaviours, barriers and needs over time, but existing maps are largely descriptive and rarely theory informed.
Objective:
To explore the behaviours, barriers and multidimensional needs of young and middle-aged patients receiving MHD across key transitional periods of the illness trajectory, using Meleis' transitions theory as an analytical lens and patient journey mapping as a visualisation tool.
Design:
A qualitative study using semi-structured in depth interviews and patient journey mapping.
Setting:
A haemodialysis centre of a tertiary hospital in Zhejiang Province, China.
Participants:
Fourteen young and middle aged patients receiving MHD (aged 18 to 59 years dialysis vintage 12 months) were purposively sampled for maximum variation.
Methods:
Semi structured interviews were conducted between September 2025 and February 2026. Data were analysed using Colaizzi's seven-step method. The illness trajectory was set as the horizontal axis, and behaviours, barriers and needs as the vertical axis to construct a journey map.
Results:
Three key transitional periods were identified: Transition I identity transition from health to patienthood (diagnosis and decision-making period), characterised by deprived cognitive preparation time and absent decision support systems; Transition II role adaptation from patient to dialysis recipient (initial adaptation period), characterised by simultaneous biopsychosocial impacts; and Transition III structural restructuring from treatment recipient to long term co exister (long term maintenance period), characterised by disrupted social time structure and chronic depletion of psychological capital. Twenty-seven themes were extracted across behaviours, barriers and needs. Needs converged on systematic cognitive support, companionate care and proactive communication of dialysis reactions, dialysis-compatible forms of employment, individualised transplantation evaluation, and peer social space.