학술논문

Perspectives of a proposed patient navigator programme for people with chronic kidney disease in rural communities: Report from national workshops.
Document Type
Article
Source
Nephrology. Nov2022, Vol. 27 Issue 11, p886-896. 11p.
Subject
*CHRONIC kidney failure
*COMMUNITIES
*PATIENTS' attitudes
*ORGAN transplant waiting lists
*RENAL replacement therapy
*ABORIGINAL Australians
*LONELINESS
*PATIENT autonomy
Language
ISSN
1320-5358
Abstract
Aims: People who live in rural areas have reduced access to appropriate and timely healthcare, leading to poorer health outcomes than their metropolitan‐based counterparts. The aims of the workshops were to ascertain participants' perspectives on barriers to access to dialysis and transplantation, to identify and prioritize the roles of a rural patient navigator, to discuss the acceptability and feasibility of implementing this role and identify possible outcomes that could be used to measure the success of the programme in a clinical trial. Methods: Rural patients (n = 19), their caregivers (n = 5) and health professionals (n = 18) from Australia participated in three workshops. We analysed the data using thematic analysis. Results: We identified four themes related to access to dialysis and transplantation: overwhelmed by separate and disconnected health systems, unprepared for emotional toll and isolation, lack of practical support and inability to develop trust and rapport. Four themes related to the role of the patient navigator programme: valuing lived experience, offering cultural expertise, requiring a conduit, and flexibility of the job description. The key roles prioritized by participants were psychological support and networking, provision/consolidation of education, and provision of practical support. Conclusion: Rural patients, caregivers and health professionals believed that programmes that include navigators with lived experience of dialysis and kidney transplantation and cultural expertise, especially for Aboriginal Australians, may have the potential to improve patient experiences in accessing healthcare. Summary at a Glance: Rural patient navigator programmes have potential to improve access to kidney replacement therapy for rural patients. Workshops were held to inform the co‐design and implementation of a rural patient navigator programme for adults with CKD, with a particular focus on improving access to all modalities of dialysis and kidney transplantation. The programme will include the features prioritized by the participants (rural patients, caregivers and their health providers) including education, cultural safety and connection, communication, valuing of lived experience and being flexible to the differing needs of people from different communities. [ABSTRACT FROM AUTHOR]