Abstract
Remote Aboriginal communities in Canada struggle with the impact of end-stage kidney disease (ESKD). Hemodialysis (HD) is the most common modality for renal replacement therapy, which often necessitates moving to urban centres. This investigation describes the illness experience of Cree from the Mushkegowuk Territory with ESKD who received HD in Kingston, Ontario and, explores the impact of relocation on their perceived quality of life (QoL). A qualitative case study approach obtained the perspectives of 4 Cree HD patients; 3 nephrologists; 3 nephrology nurses; and 3 Weeneebayko Patient Service workers. The complexity of the Cree illness experience regarding HD treatment in an urban centre included: the illness experience of the Cree HD patients consisting of an acute and a chronic phase, divergence of health beliefs which affected the clinical interactions between patients and healthcare providers, and the social and cultural isolation due to relocating for HD which reduced the perceived QoL of Cree patients. The findings are presented in models co-created with the Cree patients. Satellite renal care programs located in rural and remote Aboriginal communities may significantly improve the QoL of this population as they can adapt to their condition within a familiar cultural context.
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