Menzies School of Health Research, Charles Darwin University, Casuarina, PO Box 41096, Darwin, NT, 0811, Australia.
Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, 0870, Australia.
BMC Nephrol. 2022 Jul 9;23(1):244. doi: 10.1186/s12882-022-02856-x.
The high burden of chronic kidney disease in First Nations peoples requires urgent attention. Empowering people to self-manage their own condition is key, along with promotion of traditional knowledge and empowerment of First Nations communities. This study explores the potential of a culturally responsive tool, already found to have high acceptability and feasibility among First Nations people, to support self-management for First Nations people with kidney failure. The Stay Strong app is a holistic wellbeing intervention. This study explores the suitability of the Stay Strong app to support self-management as shown by the readiness of participants to engage in goal setting. Data were collected during a clinical trial which followed adaption of research tools and procedures through collaboration between content and language experts, and community members with lived experience of kidney failure.
First Nations (i.e., Aboriginal and Torres Strait Islander) participants receiving haemodialysis in the Northern Territory (n = 156) entered a three-arm, waitlist, single-blind randomised controlled trial which provided collaborative goal setting using the Stay Strong app at baseline or at 3 months. Qualitative data gathered during delivery of the intervention were examined using both content and thematic analysis.
Almost all participants (147, 94%) received a Stay Strong session: of these, 135 (92%) attended at least two sessions, and 83 (56%) set more than one wellbeing goal. Using a deductive approach to manifest content, 13 categories of goals were identified. The three most common were to: 'connect with family or other people', 'go bush/be outdoors' and 'go home/be on country'. Analysis of latent content identified three themes throughout the goals: 'social and emotional wellbeing', 'physical health' and 'cultural connection'.
This study provides evidence of the suitability of the Stay Strong app for use as a chronic condition self-management tool. Participants set goals that addressed physical as well as social and emotional wellbeing needs, prioritising family, country, and cultural identity. The intervention aligns directly with self-management approaches that are holistic and prioritise individual empowerment. Implementation of self-management strategies into routine care remains a key challenge and further research is needed to establish drivers of success.
第一民族人群的慢性肾病负担沉重，急需引起重视。赋予人们自我管理自身状况的能力是关键，同时还需要促进传统知识并增强第一民族社区的能力。本研究探讨了一种文化响应工具的潜力，该工具已经在第一民族人群中被发现具有很高的可接受性和可行性，可用于支持肾衰竭的第一民族人群进行自我管理。Stay Strong 应用程序是一种整体健康干预措施。本研究探讨了 Stay Strong 应用程序支持自我管理的适用性，这表现在参与者愿意参与目标设定的程度上。数据是在一项临床试验中收集的，该试验通过内容和语言专家以及有肾脏衰竭经历的社区成员之间的合作，对研究工具和程序进行了改编。
北领地（即澳大利亚原住民和托雷斯海峡岛民）接受血液透析的第一民族（即原住民和托雷斯海峡岛民）参与者（n=156）进入了一项三臂、等待名单、单盲随机对照试验，该试验在基线或 3 个月时使用 Stay Strong 应用程序提供协作目标设定。在实施干预措施期间收集的定性数据使用内容分析和主题分析进行了检查。
几乎所有参与者（147 人，占 94%）都接受了 Stay Strong 课程：其中，135 人（92%）至少参加了两次课程，83 人（56%）设定了不止一个健康目标。使用演绎方法对明显内容进行分析，确定了 13 类目标。最常见的三个目标是：“与家人或其他人建立联系”、“去野外/户外”和“回家/在自己的土地上”。潜在内容的分析确定了贯穿所有目标的三个主题：“社会和情感健康”、“身体健康”和“文化联系”。
本研究为使用 Stay Strong 应用程序作为慢性病自我管理工具提供了证据。参与者设定的目标既涉及身体，也涉及社会和情感健康需求，优先考虑家庭、国家和文化认同。该干预措施直接符合注重个体赋权的整体自我管理方法。将自我管理策略纳入常规护理仍然是一个关键挑战，需要进一步研究以确定成功的驱动因素。
