Perspectives on social health among patients from Arab backgrounds receiving kidney replacement therapy: an interview study

Background: Patients with chronic kidney disease receiving kidney replacement therapy have an increased risk of having poor social participation and connections, which are associated with poor health outcomes. This may be exacerbated in people from minority or disadvantaged groups, including culturally and linguistically diverse populations, who face multiple social disadvantages. We aimed to describe the perspectives on social health and connections among patients from Arab backgrounds receiving kidney replacement therapy. 

Methods: Semi-structured interviews were conducted in Arabic or English language with Arab Australians receiving kidney replacement therapy across four renal units within the Western Renal Service, Australia. Transcripts were thematically analysed. 

Results: Twenty-five participants were interviewed, including 13 (52%) male and 22 (88%) born overseas. Four themes were identified: treatment impeding social participation (missing out on family time, limited opportunity for close friendships, symptoms interfering with relationships, reluctant to socialize to avoid infection); diminishing community and cultural ties (stigmatized and ostracized, geographic and cultural separation, emotional disconnect, avoiding additional distress); struggling with loss of normality within the family (inability to fulfil gender roles, hiding pain to protect children); and deriving comfort from connection (cultural norms preventing loneliness, easing the burden with support from family and friends, kinship and companionship during in-centre dialysis, using technology to connect with others). 

Conclusions: Patients from Arab backgrounds face substantial barriers to social participation, leading to loss of connection with people and culture. Strategies to improve social connections through culturally tailored peer and family support are needed.