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Dubin J, Bains S, Ihekweazu UN, Mont MA, Delanois R. Social Determinants of Health in Total Joint Arthroplasty: Insurance. J Arthroplasty 2024; 39:1637-1639. [PMID: 38360281 DOI: 10.1016/j.arth.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Affiliation(s)
- Jeremy Dubin
- Rubin Institute for Advanced Orthopedics, LifeBridge Health, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Sandeep Bains
- Rubin Institute for Advanced Orthopedics, LifeBridge Health, Sinai Hospital of Baltimore, Baltimore, Maryland
| | | | - Michael A Mont
- Rubin Institute for Advanced Orthopedics, LifeBridge Health, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Ronald Delanois
- Rubin Institute for Advanced Orthopedics, LifeBridge Health, Sinai Hospital of Baltimore, Baltimore, Maryland
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Jose MD, Cuthbertson L, Burgess J, Jose K, Saunder T, Kitsos A, Radford J, Raj R. Island medicine longitudinal cohort study: Rapid rise in chronic kidney disease in rural and remote communities. Nephrology (Carlton) 2024; 29:429-437. [PMID: 38533938 DOI: 10.1111/nep.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/19/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
AIM To determine the change in incidence and prevalence of chronic kidney disease (CKD) in rural and remote communities over the last decade. METHODS We examined the change in age-standardized incidence and prevalence in Tasmania between 2010 and 2020, using a linked dataset that included any adult with a creatinine test taken in a community laboratory during the study period (n = 581 513; 87.8% of the state's adult population). We defined CKD as two measures of eGFR <60 mL/min per 1.73 m2, at least 3 months apart. RESULTS State-wide age-standardized prevalence of CKD increased by 28% in the decade to 2020, from 516 to 659 per 10 000 population. Prevalence in men increased 31.3% and women 24.8%. The greatest increase in age-standardized prevalence was seen in rural or remote communities with an increase of 36.6% overall, but with considerable variation by community (range + 0.4% to +88.3%). The increase in the actual number of people with CKD in the decade to 2020 was 67%, with the number of women increasing by 58% and men by 79%. CONCLUSION The age-standardized prevalence of CKD in rural and remote regions has increased considerably over the past decade, likely compounded by limited access to primary and secondary healthcare. These findings highlight the need to ensure healthcare resources are directed to areas of greatest need.
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Affiliation(s)
- Matthew D Jose
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Renal Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Laura Cuthbertson
- Renal Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia
- Renal Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - James Burgess
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Renal Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Kim Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Timothy Saunder
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Alex Kitsos
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Jan Radford
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Rajesh Raj
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Renal Unit, Launceston General Hospital, Launceston, Tasmania, Australia
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Recabarren J, Dominello A, Scholes-Robertson N, Jaure A, Wong G, Craig JC, Howell M. It matters who you are and where you live: Commonwealth, state and territory policies for access to care for Australians with chronic kidney disease and their caregivers. Aust N Z J Public Health 2024; 48:100131. [PMID: 38422583 DOI: 10.1016/j.anzjph.2024.100131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 11/02/2023] [Accepted: 01/09/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To describe how Commonwealth, state and territory policies address access to care for Australians living with chronic kidney disease (CKD) with an emphasis on Aboriginal and Torres Strait Islanders and people residing in rural and remote areas. METHODS We searched government health department websites for current policies up to March 2022 that addressed access to care for people with CKD. RESULTS We included 98 policies: 28 were Commonwealth, and 70 were state or territory-based. There was wide variation in the policies for people with CKD in number and type across the jurisdictions. Of CKD specific policies, only three policies were specific for people living with CKD in rural and remote areas and no policies were specific for Aboriginal and Torres Strait Islander people. CONCLUSION There is a lack of CKD-specific policies addressing access to care for Aboriginal and Torres Strait Islander people and people living in rural and remote communities. IMPLICATIONS FOR PUBLIC HEALTH Despite the known disparities in the burden of CKD there are few policies addressing CKD disparities for Aboriginal and Torres Strait Islander people and Australians living in rural and remote areas. Policies that specifically address the barriers to accessing care are required to reduce inequities.
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Affiliation(s)
- Javier Recabarren
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, The University of Sydney, NSW, Australia.
| | - Amanda Dominello
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - Nicole Scholes-Robertson
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - Allison Jaure
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, SA, Australia
| | - Martin Howell
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, The University of Sydney, NSW, Australia
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Duncanson E, Davies CE, Muthuramalingam S, Johns E, McColm K, Hempstalk M, Tasevski Z, Gray NA, McDonald SP. Patient Perspectives of Center-Specific Reporting in Kidney Failure Care: An Australian Qualitative Study. Kidney Int Rep 2024; 9:843-852. [PMID: 38765598 PMCID: PMC11101730 DOI: 10.1016/j.ekir.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Public reporting of quality of care indicators in healthcare is intended to inform consumer decision-making; however, people may be unaware that such information exists, or it may not capture their priorities. The aim of this study was to understand the views of people with kidney disease about public reporting of dialysis and transplant center outcomes. Methods This qualitative study involved 27 patients with lived experience of kidney disease in Australia who participated in 11 online focus groups between August and December 2022. Transcripts were analyzed thematically. Results Patients from all Australian states and territories participated, with 22 (81%) having a functioning kidney transplant and 22 (81%) having current or previous experience of dialysis. Five themes were identified as follows: (i) surrendering to the health system, (ii) the complexity of quality, (iii) benefits for patient care and experience, (iv) concerned about risks and unintended consequences, and (v) optimizing the impact of data. Conclusion Patients desire choice among kidney services but perceive this as rarely possible in the Australian context. Health professionals are trusted to make decisions about appropriate centers. Public reporting of center outcomes may induce fear and a loss of balanced perspective; however, it was supported by all participants and represents an opportunity for self-advocacy and informed decision-making. Strategies to mitigate potential risks include availability of trusted clinicians and community members to aid in data interpretation, providing context about centers and patients, and framing statistics to promote positivity and hope.
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Affiliation(s)
- Emily Duncanson
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Christopher E. Davies
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Shyamsundar Muthuramalingam
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Effie Johns
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kate McColm
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Matty Hempstalk
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
- Transplant Australia, Sydney, New South Wales, Australia
| | - Zoran Tasevski
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Nicholas A. Gray
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
- Renal Unit, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
- School of Health, University of Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Stephen P. McDonald
- Australia and New Zealand Dialysis and Transplant Registry, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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5
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Soonarane YK, Pollard G, Knack B, Hope M, Clark D, Naidu S, Anuradha S, Puri G. Inequity of healthcare access for patients with diabetic foot disease: a retrospective study in south-east Queensland. BMJ Open 2024; 14:e074155. [PMID: 38238174 PMCID: PMC11148679 DOI: 10.1136/bmjopen-2023-074155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVES Logan local government area (LGA) in Queensland has the highest diabetes prevalence (6.5%) within Metro South Health (MSH). The study aimed to determine the burden of, and equity of access to secondary healthcare, for diabetic foot disease (DFD) for Logan residents to better inform healthcare services planning. DESIGN A retrospective analysis of hospital admissions data between January 2018 and December 2021. SETTING, PARTICIPANTS All episodes of care for DFD provided by MSH hospitals to patients with a residential address in the three LGAs serving the region were included. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was number of episodes of care for DFD by LGA of residence and hospital of presentation. Secondary outcomes were DFD-related hospital occupied bed days and number of lower extremity amputations. RESULTS Among residents in the MSH region, almost half of all episodes of care (47%) and bed days (48%) for DFD were for patients residing in Logan LGA. 40% of episodes of care, 57% of bed days and 73% of lower extremity amputations for DFD for these patients occurred outside of Logan LGA. These findings led to the planning of an integrated model of care for DFD at Logan hospital to improve and make care available locally. CONCLUSIONS Our study suggests that Logan residents with DFD had poor access to care despite the highest burden. Analysing epidemiology of care for DFD with an equity lens and highlighting gaps in service delivery is paramount to addressing the inequity paradigm.
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Affiliation(s)
- Yudish Kumar Soonarane
- Metro South Public Health Unit, Metro South Health Service District, Woolloongabba, Queensland, Australia
| | - Gayle Pollard
- Metro South Public Health Unit, Metro South Health Service District, Woolloongabba, Queensland, Australia
| | - Brent Knack
- Healthcare Improvement Unit, Clinical Excellence Queensland, Herston, Queensland, Australia
| | - Matthew Hope
- Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Darren Clark
- Division of Internal Medicine, Logan Hospital, Meadowbrook, Queensland, Australia
| | - Sanjeev Naidu
- Department of Surgery, Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Satyamurthy Anuradha
- Metro South Public Health Unit, Metro South Health Service District, Woolloongabba, Queensland, Australia
- The University of Queensland, Saint Lucia, Queensland, Australia
| | - Gaurav Puri
- Healthcare Improvement Unit, Clinical Excellence Queensland, Herston, Queensland, Australia
- Logan Endocrine and Diabetes Services (LEADS), Logan Hospital, Metro South Health, Meadowbrook, Queensland, Australia
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Trinh E, Manera K, Scholes-Robertson N, Shen JI. The Burden of Home Dialysis: An Overlooked Challenge. Clin J Am Soc Nephrol 2024; 19:01277230-990000000-00326. [PMID: 38190177 PMCID: PMC11390025 DOI: 10.2215/cjn.0000000000000413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
Home dialysis offers several clinical and quality-of-life benefits for patients with kidney failure. However, it is important to recognize that home dialysis may place an increased burden on patients and their care partners. Sources of burden may include concerns about the ability to adequately and safely perform dialysis at home, physical symptoms, impairment of life participation, psychosocial challenges, and care partner burnout. Overlooking or failing to address these issues may lead to adverse events that negatively affect health and quality of life and reduce longevity of home dialysis. This study will explore aspects of home dialysis associated with burden, emphasize the need for increased awareness of potential challenges, and elaborate on strategies to overcome sources of burden. Future research should actively involve patients and care partners to better understand their motivation, experiences, and needs to better inform support strategies.
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Affiliation(s)
- Emilie Trinh
- Division of Nephrology, Department of Medicine, McGill University Health Center, Montreal, Canada
| | - Karine Manera
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Jenny I Shen
- Division of Nephrology and Hypertension, The Lundquist Research Institute at Harbor-UCLA Medical Center, Torrance, California
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Cundale K, McDonald SP, Irish A, Jose MD, Diack J, D'Antoine M, Owen KJ, Hughes JT. Improving equity in access to kidney transplantation: implementing targeted models of care focused on improving timely access to waitlisting. Med J Aust 2023; 219 Suppl 8:S7-S10. [PMID: 37839027 DOI: 10.5694/mja2.52099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/14/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Katie Cundale
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Stephen P McDonald
- Adelaide Medical School, University of Adelaide, Adelaide, SA
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
| | | | - Matthew D Jose
- University of Tasmania, Hobart, TAS
- Royal Hobart Hospital, Hobart, TAS
| | - Jillian Diack
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
| | - Matilda D'Antoine
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Kelli J Owen
- Adelaide Medical School, University of Adelaide, Adelaide, SA
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
| | - Jaquelyne T Hughes
- Rural and Remote Health, Flinders University, Darwin, NT
- Royal Darwin Hospital, Darwin, NT
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Tian FF, Hall YN, Griffin S, Kranze T, Marcella D, Watnick S, O'Hare AM. The Complex Patchwork of Transportation for In-Center Hemodialysis. J Am Soc Nephrol 2023; 34:1621-1627. [PMID: 37527287 PMCID: PMC10561812 DOI: 10.1681/asn.0000000000000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/02/2023] [Indexed: 08/03/2023] Open
Abstract
Reliable transportation is an important determinant of access to health care and health outcomes that carries particular significance for people with ESKD. In the United States, there are almost half a million patients receiving treatment with in-center dialysis, translating into more than 70 million roundtrips to dialysis centers annually. Difficulty with transportation can interfere with patients' quality of life and contribute to missed or shortened dialysis treatments, increasing their risk for hospitalization. Medicare, the principal payer for dialysis in this country, has not traditionally provided coverage for nonemergency medical transportation, placing the burden of traveling to and from the dialysis center on patients and families and a range of other private and public entities that were not designed and are poorly equipped for this purpose. Here, we review the relationship between access to reliable transportation and health outcomes such as missed and shortened dialysis treatments, hospitalizations, and quality of life. We also describe current approaches to the delivery of transportation for patients receiving in-center hemodialysis, highlighting potential opportunities for improvement.
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Affiliation(s)
- Frances F. Tian
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
| | - Yoshio N. Hall
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
- VA Puget Sound Health Care System, Seattle, Washington
| | | | - Torie Kranze
- National Kidney Foundation of Louisiana New Orleans, Louisiana
| | | | - Suzanne Watnick
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- VA Puget Sound Health Care System, Seattle, Washington
- Northwest Kidney Centers, Seattle, Washington
| | - Ann M. O'Hare
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
- VA Puget Sound Health Care System, Seattle, Washington
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Alhamad MA, Almulhim MY, Alburayh AA, Alsaad RA, Alhajji AM, Alnajjar JS, Alhashem SS, Salah G, Al Sahlawi M. Factors Affecting Adherence to Hemodialysis Therapy Among Patients With End-Stage Renal Disease Attending In-Center Hemodialysis in Al-Ahsa Region, Saudi Arabia. Cureus 2023; 15:e46701. [PMID: 38022334 PMCID: PMC10630638 DOI: 10.7759/cureus.46701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are global health concerns, with ESRD requiring renal replacement therapy (RRT). Hemodialysis is a prevalent modality for RRT. However, access to hemodialysis is challenging for rural patients due to geographical barriers and limited nephrology services. This research aims to identify factors influencing adherence to hemodialysis sessions among rural ESRD patients, addressing travel, healthcare infrastructure, and socioeconomic factors. Materials and methods A cross-sectional study of 154 participants was conducted from July 06 to September 10, 2023 at Al-Jaber Dialysis Center in Al-Ahsa, Saudi Arabia. It included adult CKD patients on hemodialysis who were interviewed to assess factors influencing hemodialysis adherence using a structured questionnaire. Results Our study assessed hemodialysis adherence in 154 patients in Al-Ahsa, Saudi Arabia. Gender distribution was nearly equal (male = 54.5%), with the majority aged 41-60, married, and residing in downtown areas. Hypertension (43.9%) and diabetes (32.3%) were the prevalent comorbidities. Most patients received thrice-weekly dialysis (96.15%), with family cars as the primary transportation mode (55.2%). Hypertension (43.3%) and diabetic nephropathy (40.9%) were the leading causes of CKD. Approximately 26% missed dialysis, with health issues and transportation difficulties being common reasons. Notably, adherence correlated with female gender, lower education, and family car transportation mode. Social support significantly influenced adherence, highlighting its importance in maintaining hemodialysis adherence. Conclusion Our study identified various sociodemographic and dialysis-related factors influencing adherence among hemodialysis patients in the Al-Ahsa region, Saudi Arabia. Notably, factors such as gender, education level, and transportation means significantly influenced adherence. Adequate family and social support were associated with better adherence. These findings highlight the importance of tailored interventions addressing these factors to enhance hemodialysis adherence and ultimately improve patient outcomes in this population.
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Affiliation(s)
| | - Mohammed Y Almulhim
- Nephrology, King Faisal University, Al-Ahsa, SAU
- Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | | | | | | | - Ghassan Salah
- Nephrology, King Fahad General Hospital, Al-Ahsa, SAU
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Watters TK, Glass BD, Mallett AJ. Identifying the barriers to kidney transplantation for patients in rural and remote areas: a scoping review. J Nephrol 2023:10.1007/s40620-023-01755-0. [PMID: 37656389 DOI: 10.1007/s40620-023-01755-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Populations in rural and remote areas have higher rates of chronic kidney disease and kidney failure than those in urban or metropolitan areas, and mortality rates for chronic kidney disease are almost twice as high in remote areas compared to major cities. Despite this, patients residing in regional, rural, or remote areas are less likely to be wait-listed for or receive a kidney transplant. The objective of this scoping review is to identify specific barriers to kidney transplantation for adult patients residing in rural and remote areas from the perspectives of health professionals and patients/carers. METHODS Studies were identified through database (MEDLINE, CINAHL, Emcare, Scopus) searches and assessed against inclusion criteria to determine eligibility. A descriptive content analysis was undertaken to identify and describe barriers as key themes. RESULTS The 24 selected studies included both quantitative (n = 5) and qualitative (n = 19) methodologies. In studies conducted in health professional populations (n = 10) the most prevalent themes identified were perceived social and cultural issues (80%), burden of travel and distance from treatment (60%), and system-level factors as barriers (60%). In patient/carer populations (n = 14), the most prevalent themes were limited understanding of illness and treatment options (71%), dislocation from family and support network (71%), and physical and psychosocial effects of treatment (71%). CONCLUSIONS Patients in regional, rural, and remote areas face many additional barriers to kidney transplantation, which are predominantly associated with the need to travel or relocate to access required medical testing and transplantation facilities.
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Affiliation(s)
- Tara K Watters
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
- Department of Renal Medicine, Cairns Hospital, PO Box 902, Cairns, QLD, 4870, Australia.
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Andrew J Mallett
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Department of Renal Medicine, Townsville University Hospital, Townsville, QLD, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
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Pan A, Wu Y, Chen X, Yu W, Wu X, Chen L, He L, Zheng G, Ma L. A qualitative study of psychological stress among China's frontline nurses fighting COVID-19. Arch Med Sci 2022; 18:1407-1412. [PMID: 36160350 PMCID: PMC9479703 DOI: 10.5114/aoms/151141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Aihong Pan
- Nursing Department, The First People’s Hospital of Hefei, Hefei, China
| | - Yuyan Wu
- Neonatal Intensive Care Unit, The First People’s Hospital of Hefei, Hefei, China
| | - Xiaoju Chen
- Spine Orthopedics, The First People’s Hospital of Hefei, Hefei, China
| | - Weihua Yu
- Dean’s Office, The First People’s Hospital of Hefei, Hefei, China
| | - Xufeng Wu
- Intensive Care Unit, The First People’s Hospital of Hefei, Hefei, China
| | - Lili Chen
- Infection Department, The First People’s Hospital of Hefei, Hefei, China
| | - Lei He
- Nursing Department, The First People’s Hospital of Hefei, Hefei, China
| | - Guohua Zheng
- Traditional Chinese Medicine Department, The First People’s Hospital of Hefei, Hefei, China
| | - Li Ma
- Emergency Medicine Department, The First People’s Hospital of Hefei, Hefei, China
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