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???Looking back to my family???: Indigenous Australian patients??? experience of hemodialysis
Jeannie Devitt; Alan Cass; Kate Anderson; Cilla Preece; Joan Cunningham
BMC Nephrology,13,1(2012-09-20)



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.


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.


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.


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.

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

出版者:BioMed Central Ltd

推荐引用方式:Jeannie Devitt,Alan Cass,Kate Anderson, et al. ???Looking back to my family???: Indigenous Australian patients??? experience of hemodialysis[J]. BMC Nephrology,2012,13(1)

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