Abstract
OBJECTIVE: This study employed a patient journey mapping approach to identify the multidimensional needs of individuals with end-stage renal disease (ESRD) throughout the course of hemodialysis (HD) treatment, to inform and optimize care delivery across the entire treatment trajectory. METHODS: Qualitative studies examining patients’ experiences with HD were identified through systematic searches of six domestic and international databases. Patient experiences were extracted and analyzed using inductive content analysis. Sixteen patients receiving HD at our hospital were recruited between 1 September 2025 and 30 October 2025 to participate in semi-structured interviews. Interview data were analyzed using content analysis to complement and enrich the findings from the literature. Patient journey maps were developed by integrating evidence from both the literature review and the interview data. RESULTS: A total of 28 studies were included in the analysis, from which four core themes comprising 14 subthemes were synthesized. Three key phases of the HD journey were identified: the diagnostic screening period, the adaptation and adjustment period, and the long-term maintenance period, which form the preliminary framework for the patient journey map. To further refine this framework, semi-structured interviews were conducted, which clarified themes related to patients’ tasks (17), emotions (8), and pain points (8). These insights informed the finalization of a comprehensive patient journey map. CONCLUSION: Nursing needs among patients undergoing HD are dynamic and evolve across different stages of treatment. The patient journey map developed in this study provides a theoretical foundation for delivering timely and efficient medical and social support throughout the health management process. Moreover, this study offers practical guidance for optimizing nursing care for patients receiving hemodialysis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-026-04898-x.