Increasing Home Dialysis Among Spanish-Speaking Mexican American Patients: Challenges and Opportunities
- Diversity and Equity: Other Research
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
- Eaton, Karen-Marie, Davita Clinical Research, Minneapolis, Minnesota, United States
- Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
- Radney, Danelle, DaVita Inc, Denver, Colorado, United States
- Odama, Unini, DaVita Inc, Denver, Colorado, United States
- Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
Home dialysis offers patients another treatment option for kidney failure. Since home dialysis use is lower in Mexican American patients, in this study we sought to understand experiences and uncover influencing factors and barriers that patients and care partners face.
A total of 28 participants (Mexican American patients at a dialysis provider, both in-center and home, and their care partners) were recruited to join in-person focus groups held in December 2022. Focus groups were audio and video recorded and transcribed verbatim. Groups were held in Spanish language, translated in real time by a certified interpreter, and transcribed in English. Responses were analyzed using inductive thematic analysis.
Patients reported that physicians did not make a clear connection between poor management of underlying health conditions and kidney failure; this led to difficulty accepting a kidney failure diagnosis and need for dialysis. Patients and caregivers want improved education in English and Spanish to help make the initial modality decision. Physician guidance was cited as the most important factor in the initial modality decision for Mexican American patients and care partners. Trust in physician recommendation is largely unquestioned, influenced by factors such as respect for physician authority, limited literacy, and language barriers. While most patients and care partners acknowledge the benefits of home dialysis, significant barriers included the fear of being solely responsible for a complex procedure and loss of social interaction and/or support from other dialysis patients and center staff. Unsurprisingly, care partners are a critical part of the decision to choose home dialysis. Faith plays a significant role for many respondents; many speak about their experience of disease in faith-based terms, such as trusting God.
Opportunities exist to build on the strong patient preference for physician led health information, and to focus on decreasing literacy and language barriers in the Mexican American population.