My experiences with kidney care: A qualitative study of adults in the Northern Territory of Australia living with chronic kidney disease, dialysis and transplantation


Autoři: Jaquelyne T. Hughes aff001;  Natasha Freeman aff001;  Barbara Beaton aff003;  Anne-Marie Puruntatemeri aff004;  Monica Hausin aff005;  Gerarda Tipiloura aff006;  Pamela Wood aff003;  Selina Signal aff003;  Sandawana W. Majoni aff001;  Alan Cass aff001;  Louise J. Maple-Brown aff001;  Renae Kirkham aff001
Působiště autorů: Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia aff001;  Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia aff002;  Top-End Renal Service, Darwin, NT, Australia aff003;  Elder from Pirlangimpi, Tiwi Islands, NT, Australia aff004;  Bilingual speaking renal dialysis recipient, Darwin, NT, Australia aff005;  Elder from Wurrumiyanga, Tiwi Islands, NT, Australia aff006;  Flinders University and Northern Territory Clinical School, Royal Darwin Hospital Campus, Darwin, NT, Australia aff007
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225722

Souhrn

Background

Australian healthcare quality and safety accreditation standards recommend health services partner with health care users, to ensure the highest quality of care. Aboriginal Australians with chronic and end stage kidney disease have high health care access needs.

Aim

To describe the experiences of health care users of a large government kidney healthcare service provider.

Methods

Within a government renal health service in the Top-End of the Northern Territory, we undertook a qualitative study involving in-depth interviews with 26 adult clients from urban, regional and remote settings who were living with kidney health conditions.

Results

Client characteristics included a mean age of 55 years, 55% female and 81% identifying as Aboriginal. The kidney related conditions of client participants included CKD (11, 42.3%), haemodialysis (12, 46.2%), peritoneal dialysis (1, 3.9%), and transplant (2, 7.7%). Key themes emerging from patient interviews related to perceived gaps for clients and carers including: 1) knowledge gaps about the health condition, 2) the impact of relocation in order to access centrally-based renal care, 3) healthcare staff professionalism and qualities and 4) service environments. Overall, the experiences centred on a greater need for client-centred, respectful and culturally based healthcare support. Clients recommended the need for patient-led collective care, including sustaining an Indigenous Patient Reference Group to support ongoing healthcare service decision processes. Participants included in almost equal proportion, clients with CKD (without dialysis) and clients utilising renal replacement therapy, which adds significant weight to the client-identified recommendations for highest quality of kidney care across a wide spectrum of kidney function.

Conclusion

Four major themes identified by clients related to their experience with renal care provided by this major regional health care provider: knowledge gaps of their own condition, the lived impacts of relocating to access health care, service environments, and Health Care Provider Quality. An Indigenous Patient Reference Group was one mechanism recommended to support the co-design of preferred care models.

Klíčová slova:

Allied health care professionals – Culture – Health care providers – Health services research – Chronic kidney disease – Kidneys – Medical dialysis – Renal transplantation


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 12