“Looking back to my family”: Indigenous Australian patients’ experience of hemodialysis

BMC Nephrology

Alan Cass¹  Cilla Preece²  Jeannie Devitt³  Joan Cunningham¹  Kate Anderson² 

[1] Sydney Medical School, University of Sydney, Sydney, NSW, Australia;The George Institute for Global Health, Sydney, NSW, Australia;Independent consultant anthropologist, Darwin, NT, Australia

关键词: Qualitative research;    Late diagnosis;    Health communication;    Patient care;    Life experiences;    Access to healthcare;    End stage kidney disease;    Hemodialysis;    Indigenous Australian;   

Others  :  1083097
DOI  :  10.1186/1471-2369-13-114

 received in 2012-04-12, accepted in 2012-09-17,  发布年份 2012

【 摘 要 】

Background

In common with Indigenous populations elsewhere, Indigenous Australians have higher incidence of end-stage kidney disease (ESKD), but lower transplantation rates than their non-Indigenous counterparts. Understanding how the demands of dialysis impact on, and are impacted by, the lives of Indigenous patients may provide important insight into treatment pathways and decision-making.

Methods

We conducted semi-structured interviews in 2005–06 with 146 Indigenous and 95 non-Indigenous patients from nine hospital renal wards and 17 associated dialysis centres, which together treat the majority of Indigenous Australian ESKD patients.

Results

Factors influencing treatment experience included: the impacts of late diagnosis; family separations associated with relocating for treatment; the physical and psychosocial demands of hemodialysis; and ineffective communication between health care providers and patients. Although not unique to them, Indigenous patients were more likely to experience the combined effect of all factors.

Conclusions

Social/situational circumstances profoundly affect Indigenous Australian dialysis patients’ ability to fully engage with treatment. This may ultimately affect their likelihood of receiving optimal treatment, including transplantation. Areas for improvement include: earlier diagnosis; improved linkages between specialist renal services and primary care in regional settings; more effective communication and patient education; and more systematic, transparent approaches to patient “compliance” in transplant and home dialysis guidelines.

【 授权许可】

   
2012 Anderson et al.; licensee BioMed Central Ltd.

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