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"Looking back to my family": Indigenous Australian patients' experience of hemodialysis

Anderson, Kate, Cunningham, Joan, Devitt, Jeannie, Preece, Cilla and Cass, Alan (2012). "Looking back to my family": Indigenous Australian patients' experience of hemodialysis. BMC Nephrology,13(114):1-8.

Document type: Journal Article
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IRMA ID cspargoxPUB7
NHMRC Grant No. 236204
Title "Looking back to my family": Indigenous Australian patients' experience of hemodialysis
Author Anderson, Kate
Cunningham, Joan
Devitt, Jeannie
Preece, Cilla
Cass, Alan
Journal Name BMC Nephrology
Publication Date 2012
Volume Number 13
Issue Number 114
ISSN 1471-2369   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84866491041
Start Page 1
End Page 8
Total Pages 8
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract 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.
Keywords Indigenous Australian
Hemodialysis
End stage kidney disease
Access to healthcare
Life experiences
Patient care
Health communication
Late diagnosis
Qualitative research
DOI http://dx.doi.org/10.1186/1471-2369-13-114   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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