Study explores perspective of Indigenous patients with CKD
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Kerr reports no relevant financial disclosures.
Researchers identified five common themes among Indigenous patients with chronic kidney disease when exploring their relationship to health care, according to data published in international kidney.
“Indigenous peoples are defined as those who first lived in an area and have distinct cultural, knowledge and linguistic traditions that provide the basis for a positive self-image and healthy identity,” Marianne Kerr, MPH, from the Kidney Research Center at Children’s Hospital at Westmead in Australia, and co-authors. “Many indigenous peoples with CKD experience challenges similar to those of the general population, however, may uniquely face unfair access to culturally responsive and safe health information and services. Thematic synthesis of available qualitative research on the experiences, impacts and challenges of CKD among indigenous peoples, globally, can broaden our understanding across different First Nations groups and environments.”
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In a systematic review, researchers followed the Improved Transparency of Qualitative Research Synthesis Reporting framework to examine qualitative studies published through October 7, 2021, that describe the experiences and perspectives of Indigenous adults with CKD. The researchers excluded non-English studies because of possible complications with translation.
Researchers extracted data from the study and used consolidated criteria statements to measure how well the patient’s preferences and priorities were being addressed.
Among the 1,895 studies pooled, 12 were included in the final analysis. A total of 201 Indigenous patients came from the United States, Canada, Australia and New Zealand. Overall, 47% of patients had CKD that did not require renal replacement therapy.
The researchers identified the following five themes: disadvantaged by inadequate health knowledge; discrimination and fear of the health care system; fear of social disconnection; rely on relatives and kinship; and face barriers to transplantation.
“Collecting the life experiences of indigenous peoples with CKD from the included studies reveals many strengths derived from their kinship ties, staying in their homeland, and sharing their experiences through storytelling. This connection facilitates self-determination and helps them face health challenges,” write Kerr and colleagues. “In contrast, the effects of colonization impact their chances of obtaining adequate health literacy, and mean they experience discrimination in the health care system, lack of cultural security, and barriers to treatment, which collectively lead to distrust and reluctance to seek care.”
They added, “We recommend one pathway to improve the experience of indigenous peoples with CKD globally is to include and prioritize indigenous voices in the development of culture-specific guidelines to minimize variation in treatment and improve health outcomes of CKD in indigenous peoples.”
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