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

Jaqui Hughes, Natasha Freeman, Barbara Beaton, A.-M. Puruntatemeri, Monica Hausin, Gerarda Tipiloura, Pamela Wood, Selina Signal, Sandawana William Majoni, Alan Cass, Louise Maple-Brown, Renae Kirkham

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    Abstract

    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.

    Original languageEnglish
    Article numbere0225722
    JournalPLoS One
    Volume14
    Issue number12
    DOIs
    Publication statusPublished - 19 Dec 2019

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