Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
Abstract Introduction First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Na...
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Online Access: | http://dx.doi.org/10.5694/mja2.52114 https://onlinelibrary.wiley.com/doi/pdf/10.5694/mja2.52114 |
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crwiley:10.5694/mja2.52114 2024-05-19T07:40:19+00:00 Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary Tunnicliffe, David J Bateman, Samantha Arnold‐Chamney, Melissa Dwyer, Karen M Howell, Martin Gebadi, Azaria Jesudason, Shilpa Kelly, Janet Lambert, Kelly Majoni, Sandawan William Oliva, Dora Owen, Kelli J Pearson, Odette Rix, Elizabeth Roberts, Ieyesha Stirling‐Kelly, Ro‐Anne Taylor, Kimberly Wittert, Gary A Widders, Katherine Yip, Adela Craig, Jonathan Phoon, Richard K National Health and Medical Research Council 2023 http://dx.doi.org/10.5694/mja2.52114 https://onlinelibrary.wiley.com/doi/pdf/10.5694/mja2.52114 en eng Wiley http://creativecommons.org/licenses/by/4.0/ Medical Journal of Australia volume 219, issue 8, page 374-385 ISSN 0025-729X 1326-5377 General Medicine journal-article 2023 crwiley https://doi.org/10.5694/mja2.52114 2024-04-22T07:36:28Z Abstract Introduction First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Nations Australians. Nationwide community consultation (Kidney Health Australia, Yarning Kidneys, and Lowitja Institute, Catching Some Air) identified priority issues for guideline development. These guidelines uniquely prioritised the knowledge of the community, alongside relevant evidence using an adapted GRADE Evidence to Decision framework to develop specific recommendations for the management of CKD among First Nations Australians. Main recommendations These guidelines explicitly state that health systems have to measure, monitor and evaluate institutional racism and link it to cultural safety training, as well as increase community and family involvement in clinical care and equitable transport and accommodation. The guidelines recommend earlier CKD screening criteria (age ≥ 18 years) and referral to specialists services with earlier criteria of kidney function (eg, estimated glomerular filtration rate [eGFR], ≤ 45 mL/min/1.73 m 2 , and a sustained decrease in eGFR, > 10 mL/min/1.73 m 2 per year) compared with the general population. Changes in management as result of the guidelines Our recommendations prioritise health care service delivery changes to address institutional racism and ensure meaningful cultural safety training. Earlier detection of CKD and referral to nephrologists for First Nations Australians has been recommended to ensure timely implementation to preserve kidney function given the excess burden of disease. Finally, the importance of community with the recognition of involvement in all aspects and stages of treatment together with increased access to care on Country, particularly in rural and remote locations, including dialysis services. Article in Journal/Newspaper First Nations Wiley Online Library Medical Journal of Australia 219 8 374 385 |
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General Medicine Tunnicliffe, David J Bateman, Samantha Arnold‐Chamney, Melissa Dwyer, Karen M Howell, Martin Gebadi, Azaria Jesudason, Shilpa Kelly, Janet Lambert, Kelly Majoni, Sandawan William Oliva, Dora Owen, Kelli J Pearson, Odette Rix, Elizabeth Roberts, Ieyesha Stirling‐Kelly, Ro‐Anne Taylor, Kimberly Wittert, Gary A Widders, Katherine Yip, Adela Craig, Jonathan Phoon, Richard K Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary |
topic_facet |
General Medicine |
description |
Abstract Introduction First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Nations Australians. Nationwide community consultation (Kidney Health Australia, Yarning Kidneys, and Lowitja Institute, Catching Some Air) identified priority issues for guideline development. These guidelines uniquely prioritised the knowledge of the community, alongside relevant evidence using an adapted GRADE Evidence to Decision framework to develop specific recommendations for the management of CKD among First Nations Australians. Main recommendations These guidelines explicitly state that health systems have to measure, monitor and evaluate institutional racism and link it to cultural safety training, as well as increase community and family involvement in clinical care and equitable transport and accommodation. The guidelines recommend earlier CKD screening criteria (age ≥ 18 years) and referral to specialists services with earlier criteria of kidney function (eg, estimated glomerular filtration rate [eGFR], ≤ 45 mL/min/1.73 m 2 , and a sustained decrease in eGFR, > 10 mL/min/1.73 m 2 per year) compared with the general population. Changes in management as result of the guidelines Our recommendations prioritise health care service delivery changes to address institutional racism and ensure meaningful cultural safety training. Earlier detection of CKD and referral to nephrologists for First Nations Australians has been recommended to ensure timely implementation to preserve kidney function given the excess burden of disease. Finally, the importance of community with the recognition of involvement in all aspects and stages of treatment together with increased access to care on Country, particularly in rural and remote locations, including dialysis services. |
author2 |
National Health and Medical Research Council |
format |
Article in Journal/Newspaper |
author |
Tunnicliffe, David J Bateman, Samantha Arnold‐Chamney, Melissa Dwyer, Karen M Howell, Martin Gebadi, Azaria Jesudason, Shilpa Kelly, Janet Lambert, Kelly Majoni, Sandawan William Oliva, Dora Owen, Kelli J Pearson, Odette Rix, Elizabeth Roberts, Ieyesha Stirling‐Kelly, Ro‐Anne Taylor, Kimberly Wittert, Gary A Widders, Katherine Yip, Adela Craig, Jonathan Phoon, Richard K |
author_facet |
Tunnicliffe, David J Bateman, Samantha Arnold‐Chamney, Melissa Dwyer, Karen M Howell, Martin Gebadi, Azaria Jesudason, Shilpa Kelly, Janet Lambert, Kelly Majoni, Sandawan William Oliva, Dora Owen, Kelli J Pearson, Odette Rix, Elizabeth Roberts, Ieyesha Stirling‐Kelly, Ro‐Anne Taylor, Kimberly Wittert, Gary A Widders, Katherine Yip, Adela Craig, Jonathan Phoon, Richard K |
author_sort |
Tunnicliffe, David J |
title |
Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary |
title_short |
Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary |
title_full |
Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary |
title_fullStr |
Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary |
title_full_unstemmed |
Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary |
title_sort |
recommendations for culturally safe clinical kidney care for first nations australians: a guideline summary |
publisher |
Wiley |
publishDate |
2023 |
url |
http://dx.doi.org/10.5694/mja2.52114 https://onlinelibrary.wiley.com/doi/pdf/10.5694/mja2.52114 |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Medical Journal of Australia volume 219, issue 8, page 374-385 ISSN 0025-729X 1326-5377 |
op_rights |
http://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.5694/mja2.52114 |
container_title |
Medical Journal of Australia |
container_volume |
219 |
container_issue |
8 |
container_start_page |
374 |
op_container_end_page |
385 |
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1799479893328658432 |