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BMC Nephrol. 2015 Apr 9;16:49. doi: 10.1186/s12882-015-0045-1.

Perceptions about hemodialysis and transplantation among African American adults with end-stage renal disease: inferences from focus groups.

Salter ML1,2,3,4, Kumar K5,6, Law AH7,8, Gupta N9,10, Marks K11,12, Balhara K13,14, McAdams-DeMarco MA15,16,17, Taylor LA18,19, Segev DL20,21,22.

Author information

1
Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA. meg@jhmi.edu.
2
Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA. meg@jhmi.edu.
3
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. meg@jhmi.edu.
4
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. meg@jhmi.edu.
5
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. komalkumar91@gmail.com.
6
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. komalkumar91@gmail.com.
7
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. alaw6@jhu.edu.
8
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. alaw6@jhu.edu.
9
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ngupta21@jhmi.edu.
10
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. ngupta21@jhmi.edu.
11
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ktmac209@gmail.com.
12
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. ktmac209@gmail.com.
13
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. kamna.balhara@gmail.com.
14
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. kamna.balhara@gmail.com.
15
Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA. mmcadam4@jhmi.edu.
16
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. mmcadam4@jhmi.edu.
17
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. mmcadam4@jhmi.edu.
18
Johns Hopkins University School of Nursing, Baltimore, MD, USA. laura.taylor@jhu.edu.
19
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. laura.taylor@jhu.edu.
20
Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA. dorry@jhmi.edu.
21
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. dorry@jhmi.edu.
22
Johns Hopkins Medical Institutions, 720 Rutland Ave, Turner 034, Baltimore, MD, 21205, USA. dorry@jhmi.edu.

Abstract

BACKGROUND:

Disparities in access to kidney transplantation (KT) remain inadequately understood and addressed. Detailed descriptions of patient attitudes may provide insight into mechanisms of disparity. The aims of this study were to explore perceptions of dialysis and KT among African American adults undergoing hemodialysis, with particular attention to age- and sex-specific concerns.

METHODS:

Qualitative data on experiences with hemodialysis and views about KT were collected through four age- and sex-stratified (males <65, males ≥65, females <65, and females ≥65 years) focus group discussions with 36 African American adults recruited from seven urban dialysis centers in Baltimore, Maryland.

RESULTS:

Four themes emerged from thematic content analysis: 1) current health and perceptions of dialysis, 2) support while undergoing dialysis, 3) interactions with medical professionals, and 4) concerns about KT. Females and older males tended to be more positive about dialysis experiences. Younger males expressed a lack of support from friends and family. All participants shared feelings of being treated poorly by medical professionals and lacking information about renal disease and treatment options. Common concerns about pursuing KT were increased medication burden, fear of surgery, fear of organ rejection, and older age (among older participants).

CONCLUSIONS:

These perceptions may contribute to disparities in access to KT, motivating granular studies based on the themes identified.

PMID:
25881073
PMCID:
PMC4395977
DOI:
10.1186/s12882-015-0045-1
[Indexed for MEDLINE]
Free PMC Article

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