Community-Based Dialysis in Saskatchewan First Nations: A Grassroots Approach to Gaining Insight and Perspective From First Nations Patients With Chronic Kidney Disease

• Published in: Canadian Journal of Kidney Health and Disease
• Main Authors: Richels, Lindsay, Sutherland, Wilson, Prettyshield, Kyle, Kappel, Joanne, McCarron, Michelle, Richardson, Bonnie
• Other Authors: Health Research Foundation’s Collaborative Innovation Development Grants Program
• Format: Article in Journal/Newspaper
• Language: English
• Published: SAGE Publications 2020
• Subjects: Nephrology; First Nations
• Online Access: http://dx.doi.org/10.1177/2054358120914689; http://journals.sagepub.com/doi/pdf/10.1177/2054358120914689; http://journals.sagepub.com/doi/full-xml/10.1177/2054358120914689

Background: Renal replacement options or dialysis can be delivered in the home setting or hospital setting. Home dialysis offers a number of benefits over hospital-delivered dialysis. These advantages include improved quality of life, less travel, and fewer dietary restrictions. Despite the benefits, home-based dialysis therapies are significantly underutilized by First Nations with only 16.2% uptake versus 25.7% uptake in non-First Nations people in Saskatchewan. It is important to recognize that First Nations have a greater burden of end-stage renal disease including higher prevalence, younger age at diagnosis, increased severity of disease, mortality at an earlier age, and increased travel distance to access kidney services. Objective: The goal of this study is to identify the existing barriers to home peritoneal dialysis and provide insight for future programs in Saskatchewan First Nations communities in a culturally meaningful framework. Design: Through qualitative research utilizing sharing circles and individual interviews, barriers to utilizing home-based dialysis were identified. Setting: Four sharing circles were held and interviews were conducted with four First Nations dialysis patients. Participants: Total number of participants in sharing circles were 67. Sharing circles were composed of patients with chronic kidney disease, patients on hospital-based dialysis, patients on home-based peritoneal dialysis, family members, health care providers (nurses, physicians, dietitians, primary care director, and coordinators). Face-to-face interviews were conducted with four First Nations dialysis patients. Measurements: The data from the sharing circles and interviews were transcribed and analyzed by a PhD researcher using constructivist grounded theory, with elements of narrative inquiry to ascertain participants’ experiences of care. Data were coded and then grouped into categories using qualitative research software NVivo. Saturation of data was achieved. Methods: Documenting and recounting patient and ...