Abstract
Purpose
During March 2021 to February 2022, within a local pandemic preparation and response phase in the Northern Territory (Australia), the New Start Dialysis Transition Programme (NSDTP) extended usual services by designing and implementing three activities aimed to support patients with kidney failure to Live Strong after starting dialysis: a) incorporation of COVID-safe education at group health education sessions, b) Frailty to Fit restorative physiotherapy and c) a COVID and culturally-safe, frailty-enabled transport service. This qualitative study evaluated these initiatives within the broader socio-environmental context.
Methods
The study was guided by an evolved Grounded Theory approach. Feedback was gained from 61 participants, involving Aboriginal and Torres Strait Islander people with lived experience of dialysis care, their family caregivers, health professionals and Indigenous Patient Reference Group members.
Main findings
Multiple data sources and a related comprehensive thematic analysis generated six key themes: 1) COVID-safe education delivery enabled family learning, was culturally respectful and strengths-based; 2) physiotherapy was personalised and patients experienced enjoyment; and 3) the transport service accommodated frailty needs and supported COVID safety needs. Participants also reported that within the broader socio-environmental context Live Strong meant: 4) living with purpose and dignity; and 5) living for the family, culture and the Country. Thus, participants recommended that 6) health systems could enable patients to ‘Live Strong’ by providing cultural understanding and patient safety across all healthcare settings they used.
Principal conclusions
Participants confirmed acceptability and recommended sustainability of three innovative services. These were designed, delivered and incorporated within usual care during the local COVID pandemic preparation and response. Success was credited to service flexibility that prioritised patient needs, family-inclusive care, and empathetic and respectful staff who had good cultural understanding of kidney care and strong team collaboration. Participants also recommended health systems to support the transferability of those success attributes to other healthcare settings.
During March 2021 to February 2022, within a local pandemic preparation and response phase in the Northern Territory (Australia), the New Start Dialysis Transition Programme (NSDTP) extended usual services by designing and implementing three activities aimed to support patients with kidney failure to Live Strong after starting dialysis: a) incorporation of COVID-safe education at group health education sessions, b) Frailty to Fit restorative physiotherapy and c) a COVID and culturally-safe, frailty-enabled transport service. This qualitative study evaluated these initiatives within the broader socio-environmental context.
Methods
The study was guided by an evolved Grounded Theory approach. Feedback was gained from 61 participants, involving Aboriginal and Torres Strait Islander people with lived experience of dialysis care, their family caregivers, health professionals and Indigenous Patient Reference Group members.
Main findings
Multiple data sources and a related comprehensive thematic analysis generated six key themes: 1) COVID-safe education delivery enabled family learning, was culturally respectful and strengths-based; 2) physiotherapy was personalised and patients experienced enjoyment; and 3) the transport service accommodated frailty needs and supported COVID safety needs. Participants also reported that within the broader socio-environmental context Live Strong meant: 4) living with purpose and dignity; and 5) living for the family, culture and the Country. Thus, participants recommended that 6) health systems could enable patients to ‘Live Strong’ by providing cultural understanding and patient safety across all healthcare settings they used.
Principal conclusions
Participants confirmed acceptability and recommended sustainability of three innovative services. These were designed, delivered and incorporated within usual care during the local COVID pandemic preparation and response. Success was credited to service flexibility that prioritised patient needs, family-inclusive care, and empathetic and respectful staff who had good cultural understanding of kidney care and strong team collaboration. Participants also recommended health systems to support the transferability of those success attributes to other healthcare settings.
| Original language | English |
|---|---|
| Article number | 100001 |
| Number of pages | 16 |
| Journal | First Nations Health and Wellbeing – The Lowitja Journal |
| Volume | 1 |
| DOIs | |
| Publication status | Published - 1 Dec 2023 |
Keywords
- Aboriginal
- Dialysis
- End-stage kidney disease
- COVID
- Culturally safe
- Live Strong
