Pascoe Sophie, Croker David, Ross Lachlan, Henwood Peter, Wilkshire Neil, Algy Cedrina, Bob Selina, Hall Heather, Misener Michelle, Gorham Gillian
Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Casuarina, Northern Territory, Australia.
Panuku, Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation (Purple House), Darwin, Northern Territory, Australia.
Health Promot J Austr. 2025 Apr;36(2):e70000. doi: 10.1002/hpja.70000.
Whilst Aboriginal and Torres Strait Islander people in Australia experience disproportionately high rates of chronic kidney disease, they have lower rates of kidney transplantation and face many barriers to accessing culturally safe health care. Aboriginal kidney health mentors with lived experience of transplantation have been proposed to improve the patient journey and increase health promotion, but there has been limited evaluation of the role of mentors.
A qualitative evaluation of the 'Hunting Kidney Transplant' patient mentoring project implemented by Purple House in the Northern Territory involved in-depth interviews, focus groups and participant observation with Aboriginal kidney health mentors and renal staff. Data analysis methods included inductive thematic coding and collaborative synthesis of emerging themes with Aboriginal co-researchers.
Aboriginal kidney health mentors play a holistic and multi-directional role helping people to navigate the transplant process. The role of mentors encompasses both visible and invisible work and is centred on a 'Right Way Working' approach, including building trust, respect and taking time during the work-up period. Key enablers include kinship and community connections and ongoing support from Purple House. Key barriers include COVID-19 and institutional racism within the mainstream health service.
Aboriginal health mentors with lived experience of chronic conditions can play an important role in supporting people and promoting cultural safety in health services. SO WHAT?: Further support and funding are needed to develop, evaluate and embed the mentor role into policy and practice to improve patient journeys, health promotion, transplant rates and health outcomes.
虽然澳大利亚的原住民和托雷斯海峡岛民患慢性肾病的比例极高,但他们接受肾脏移植的比例较低,并且在获得符合文化安全的医疗保健方面面临诸多障碍。有人提议由有肾脏移植亲身经历的原住民肾脏健康导师来改善患者就医过程并加强健康促进工作,但对导师角色的评估有限。
对北领地紫屋实施的“追寻肾脏移植”患者指导项目进行定性评估,涉及与原住民肾脏健康导师及肾脏科工作人员进行深度访谈、焦点小组讨论和参与观察。数据分析方法包括归纳主题编码以及与原住民共同研究者对新出现的主题进行协作综合分析。
原住民肾脏健康导师在帮助人们应对移植过程中发挥着全面且多方向的作用。导师的角色涵盖可见和不可见的工作,以“正确工作方式”为核心,包括在检查阶段建立信任、尊重并花费时间。关键促成因素包括亲属关系和社区联系以及紫屋的持续支持。关键障碍包括新冠疫情和主流医疗服务体系内的制度性种族主义。
有慢性病亲身经历的原住民健康导师在为人们提供支持以及促进医疗服务中的文化安全方面可发挥重要作用。那又如何?:需要进一步的支持和资金来发展、评估导师角色并将其纳入政策和实践中,以改善患者就医过程、健康促进、移植率和健康结果。