Barriers to accounting

Australian Indigenous students’ experience

Hassan Rkein, Gweneth Norris

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    Abstract

    Background: Indigenous Australians are slightly morethan 2% of the total Australian population however, in recent years they havecomprised between 6 and 10% of new patients beginning treatment for end-stagekidney disease (ESKD). Although transplant is considered the optimal form oftreatment for many ESKD patients there is a pronounced disparity between therates at which Indigenous ESKD patients receive transplants compared with theirnon-Indigenous counterparts. The IMPAKT (Improving Access to KidneyTransplants) Interview study investigated reasons for this disparity through alarge scale, in-depth interview study involving patients, nephrologists and keydecision-making staff at selected Australian transplant and dialysis sites.

    Methods: The design and conduct of the study reflected the multi-disciplinarymembership of the core IMPAKT team. Promoting a participatory ethos, IMPAKTestablished partnerships with a network of hospital transplant units andhospital dialysis treatment centres that provide treatment to the vast majorityof Indigenous patients across Australia. Under their auspices, the IMPAKT teamconducted in-depth interviews in 26 treatment/service centres located inmetropolitan, regional and remote Australia. Peer interviewing supported theengagement of Indigenous patients (146), and nephrologists (19). In totalIMPAKT spoke with Indigenous and non-Indigenous patients (241), key renalnursing and other (non-specialist) staff (95) and a small number of relevantothers (28). Data analysis was supported by QSR software. At each site, IMPAKTalso documented educational programs and resources, mapped an hypothetical‘patient journey’ to transplant through the local system and observed patientcare and treatment routines.

    Discussion: The national scope, inter-disciplinaryapproach and use of qualitative methods in an investigation of a significanthealth inequality affecting Indigenous people is, we believe, an Australianfirst. An exceptionally large cohort of Indigenous participants providedevaluative comment on their health services in relation to dialysis andtransplant. Additionally, the data includes extensive parallel commentary froma cohort of specialists, nurses and other staff. The study considers a ‘patientjourney’ to transplant within a diverse range of Australian treatmentcentre/workplace settings. The IMPAKT Interview study protocol may contributeto improvements in multi-disciplinary, flexible design health services researchwith hard to reach or vulnerable populations in Australia and elsewhere.

    Original languageEnglish
    Pages (from-to)95-107
    Number of pages13
    JournalSocial and Environmental Accountability Journal
    Volume32
    Issue number2
    DOIs
    Publication statusPublished - 2012

    Fingerprint

    Dialysis
    Staff
    In-depth interviews
    Health services
    Cohort
    Vulnerable populations
    Education
    Peers
    Work place
    Resources
    Interviewing
    Software
    Qualitative methods
    Nurses
    Indigenous peoples
    Ethos

    Cite this

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    title = "Barriers to accounting: Australian Indigenous students’ experience",
    abstract = "Background: Indigenous Australians are slightly morethan 2{\%} of the total Australian population however, in recent years they havecomprised between 6 and 10{\%} of new patients beginning treatment for end-stagekidney disease (ESKD). Although transplant is considered the optimal form oftreatment for many ESKD patients there is a pronounced disparity between therates at which Indigenous ESKD patients receive transplants compared with theirnon-Indigenous counterparts. The IMPAKT (Improving Access to KidneyTransplants) Interview study investigated reasons for this disparity through alarge scale, in-depth interview study involving patients, nephrologists and keydecision-making staff at selected Australian transplant and dialysis sites.Methods: The design and conduct of the study reflected the multi-disciplinarymembership of the core IMPAKT team. Promoting a participatory ethos, IMPAKTestablished partnerships with a network of hospital transplant units andhospital dialysis treatment centres that provide treatment to the vast majorityof Indigenous patients across Australia. Under their auspices, the IMPAKT teamconducted in-depth interviews in 26 treatment/service centres located inmetropolitan, regional and remote Australia. Peer interviewing supported theengagement of Indigenous patients (146), and nephrologists (19). In totalIMPAKT spoke with Indigenous and non-Indigenous patients (241), key renalnursing and other (non-specialist) staff (95) and a small number of relevantothers (28). Data analysis was supported by QSR software. At each site, IMPAKTalso documented educational programs and resources, mapped an hypothetical‘patient journey’ to transplant through the local system and observed patientcare and treatment routines.Discussion: The national scope, inter-disciplinaryapproach and use of qualitative methods in an investigation of a significanthealth inequality affecting Indigenous people is, we believe, an Australianfirst. An exceptionally large cohort of Indigenous participants providedevaluative comment on their health services in relation to dialysis andtransplant. Additionally, the data includes extensive parallel commentary froma cohort of specialists, nurses and other staff. The study considers a ‘patientjourney’ to transplant within a diverse range of Australian treatmentcentre/workplace settings. The IMPAKT Interview study protocol may contributeto improvements in multi-disciplinary, flexible design health services researchwith hard to reach or vulnerable populations in Australia and elsewhere.",
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    Barriers to accounting : Australian Indigenous students’ experience. / Rkein, Hassan; Norris, Gweneth.

    In: Social and Environmental Accountability Journal, Vol. 32, No. 2, 2012, p. 95-107.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Barriers to accounting

    T2 - Australian Indigenous students’ experience

    AU - Rkein, Hassan

    AU - Norris, Gweneth

    PY - 2012

    Y1 - 2012

    N2 - Background: Indigenous Australians are slightly morethan 2% of the total Australian population however, in recent years they havecomprised between 6 and 10% of new patients beginning treatment for end-stagekidney disease (ESKD). Although transplant is considered the optimal form oftreatment for many ESKD patients there is a pronounced disparity between therates at which Indigenous ESKD patients receive transplants compared with theirnon-Indigenous counterparts. The IMPAKT (Improving Access to KidneyTransplants) Interview study investigated reasons for this disparity through alarge scale, in-depth interview study involving patients, nephrologists and keydecision-making staff at selected Australian transplant and dialysis sites.Methods: The design and conduct of the study reflected the multi-disciplinarymembership of the core IMPAKT team. Promoting a participatory ethos, IMPAKTestablished partnerships with a network of hospital transplant units andhospital dialysis treatment centres that provide treatment to the vast majorityof Indigenous patients across Australia. Under their auspices, the IMPAKT teamconducted in-depth interviews in 26 treatment/service centres located inmetropolitan, regional and remote Australia. Peer interviewing supported theengagement of Indigenous patients (146), and nephrologists (19). In totalIMPAKT spoke with Indigenous and non-Indigenous patients (241), key renalnursing and other (non-specialist) staff (95) and a small number of relevantothers (28). Data analysis was supported by QSR software. At each site, IMPAKTalso documented educational programs and resources, mapped an hypothetical‘patient journey’ to transplant through the local system and observed patientcare and treatment routines.Discussion: The national scope, inter-disciplinaryapproach and use of qualitative methods in an investigation of a significanthealth inequality affecting Indigenous people is, we believe, an Australianfirst. An exceptionally large cohort of Indigenous participants providedevaluative comment on their health services in relation to dialysis andtransplant. Additionally, the data includes extensive parallel commentary froma cohort of specialists, nurses and other staff. The study considers a ‘patientjourney’ to transplant within a diverse range of Australian treatmentcentre/workplace settings. The IMPAKT Interview study protocol may contributeto improvements in multi-disciplinary, flexible design health services researchwith hard to reach or vulnerable populations in Australia and elsewhere.

    AB - Background: Indigenous Australians are slightly morethan 2% of the total Australian population however, in recent years they havecomprised between 6 and 10% of new patients beginning treatment for end-stagekidney disease (ESKD). Although transplant is considered the optimal form oftreatment for many ESKD patients there is a pronounced disparity between therates at which Indigenous ESKD patients receive transplants compared with theirnon-Indigenous counterparts. The IMPAKT (Improving Access to KidneyTransplants) Interview study investigated reasons for this disparity through alarge scale, in-depth interview study involving patients, nephrologists and keydecision-making staff at selected Australian transplant and dialysis sites.Methods: The design and conduct of the study reflected the multi-disciplinarymembership of the core IMPAKT team. Promoting a participatory ethos, IMPAKTestablished partnerships with a network of hospital transplant units andhospital dialysis treatment centres that provide treatment to the vast majorityof Indigenous patients across Australia. Under their auspices, the IMPAKT teamconducted in-depth interviews in 26 treatment/service centres located inmetropolitan, regional and remote Australia. Peer interviewing supported theengagement of Indigenous patients (146), and nephrologists (19). In totalIMPAKT spoke with Indigenous and non-Indigenous patients (241), key renalnursing and other (non-specialist) staff (95) and a small number of relevantothers (28). Data analysis was supported by QSR software. At each site, IMPAKTalso documented educational programs and resources, mapped an hypothetical‘patient journey’ to transplant through the local system and observed patientcare and treatment routines.Discussion: The national scope, inter-disciplinaryapproach and use of qualitative methods in an investigation of a significanthealth inequality affecting Indigenous people is, we believe, an Australianfirst. An exceptionally large cohort of Indigenous participants providedevaluative comment on their health services in relation to dialysis andtransplant. Additionally, the data includes extensive parallel commentary froma cohort of specialists, nurses and other staff. The study considers a ‘patientjourney’ to transplant within a diverse range of Australian treatmentcentre/workplace settings. The IMPAKT Interview study protocol may contributeto improvements in multi-disciplinary, flexible design health services researchwith hard to reach or vulnerable populations in Australia and elsewhere.

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    JO - Social and Environmental Accountability Journal

    JF - Social and Environmental Accountability Journal

    SN - 2156-2245

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