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

BMC Nephrology

Research Article

Jeannie Devitt¹  Joan Cunningham²  Cilla Preece³  Kate Anderson³  Alan Cass⁴ 

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

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

DOI  :  10.1186/1471-2369-13-114

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

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsWe 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.ResultsFactors 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.ConclusionsSocial/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】

Unknown   
© Anderson et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.