J CONWAY1, S LAWN2, S CRAIL1,3, S MCDONALD1,3
1Royal Adelaide Hospital, Adelaide, Australia, 2Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Bedford Park, Australia, 3Central Adelaide Renal and Transplantation Service, Adelaide, Australia
Aim: To qualitatively evaluate the impact of the South Australian Mobile Dialysis Truck program on the health and wellbeing of Indigenous dialysis patients, and the facilitators and barriers to using the service.
Background: Many Indigenous Australians from remote areas with End-Stage Kidney Disease relocate to metropolitan centres to access regular haemodialysis. The SA Mobile Dialysis Truck was designed to address this dislocation from family and country, providing opportunities to reunite patients with friends and family by visiting remote communities for one to two weeks.
Methods: Face to face semi-structured interviews occurred with 15 Indigenous dialysis patients and 10 nurses across seven dialysis units who had attended trips. Realist evaluation methodology and thematic analysis sought patient and nursing experiences.
Results: The consequences of leaving country included grief and loss. Lower trip frequency, poor advertisement and lack of accommodation for staff and patients and poor health were barriers to attendance. Benefits included fulfilment of cultural commitments; minimisation of medical retrievals from remote areas; improved trust and relationships between patients and staff and improved patient quality of life. The truck provided a valuable cultural learning opportunity for staff. Facilitators to successful trips included support staff, clinical back-up and a co-ordinator role.
Conclusions: The Dialysis Truck improved the social and emotional wellbeing of Indigenous patients who relocated for dialysis and built positive relationships and trust between metropolitan nurses and remote patients fostering improved engagement. It also provided valuable cultural learning opportunities for nursing staff.
I am currently working as an Advanced Trainee in Renal Medicine at the Royal Prince Alfred Hospital having previously worked at the Royal Adelaide Hospital. I am a qualitative researcher with interests in rural and remote health, in particular Indigenous health.