Mercado-Martinez Francisco J, da Silva Denise Guerreiro V, Correa-Mauricio Mauricio E
Universidad de Guadalajara, Guadalajara, Jalisco, México.
Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil.
Nurs Inq. 2017 Apr;24(2). doi: 10.1111/nin.12163. Epub 2016 Sep 27.
Renal replacement therapy is the indicated treatment for individuals with chronic kidney disease (CKD) to survive. However, not all sick people have access to the same treatment. This study compares renal care in two developing countries with different health systems. Specifically, it explores hemodialysis treatment from the perspective of low-income individuals. A qualitative, comparative study was performed in Brazil and Mexico. Using purposive sampling, the research was based on open-ended interviews with nineteen participants with kidney failure undergoing hemodialysis treatment in public hospitals and ten relatives. According to our results, Brazilian participants perceived hemodialysis care as satisfactory because of health personnel courtesy as well as free access to dialysis treatment, prescription drugs, hospitalization and transportation. However, they reported deficiencies in the care they were receiving due to shortages of specialists, prescription drugs, laboratory tests and transportation. Mexican participants, in contrast, highlighted the catastrophic costs of medical care because they had no free access to renal therapy, nor adequate financial resources. Our findings suggest that low-income Brazilian CKD sufferers experience renal care differently, as they are more satisfied and face less obstacles with hemodialysis compared with those of Mexico. More studies on the topic are needed.
肾脏替代疗法是慢性肾脏病（CKD）患者赖以生存的指定治疗方法。然而，并非所有患者都能获得相同的治疗。本研究比较了两个拥有不同卫生系统的发展中国家的肾脏护理情况。具体而言，它从低收入人群的角度探讨了血液透析治疗。在巴西和墨西哥进行了一项定性比较研究。采用目的抽样法，该研究基于对19名在公立医院接受血液透析治疗的肾衰竭患者和10名亲属进行的开放式访谈。根据我们的结果，巴西参与者认为血液透析护理令人满意，这是因为医护人员态度亲切，而且可以免费获得透析治疗、处方药、住院治疗和交通服务。然而，他们报告称，由于专科医生短缺、处方药短缺、实验室检查不足和交通不便，他们所接受的护理存在缺陷。相比之下，墨西哥参与者则强调了医疗护理的灾难性费用，因为他们无法免费获得肾脏治疗，也没有足够的经济资源。我们的研究结果表明，巴西低收入CKD患者对肾脏护理的体验有所不同，与墨西哥患者相比，他们对血液透析更满意，面临的障碍也更少。需要对该主题进行更多研究。
