Prevalence Of Kidney Diseases Amongst Aboriginal Community In Australia

Kidney failures and renal problems are quite prevalent amongst the aboriginal community in Australia and can be more observed in older individuals, aged 70 and above. In the years 2017- 2018, maximum people in Australia were hospitalised for the cause of needing “care with dialysis”. The Aboriginal population is mostly found in the “Northern Territory”, where there is an extremely high prevalence of kidney disorders (Thomson et al., 2019). There are multiple complex reasons for the high rates found, involving an increased susceptibility to the damage to kidneys through genetic predisposition, higher diabetes rates and being prematurely born with smaller kidneys and constant rates of infection. Having improper access to nutritional food, limited states of education, and substandard housing increases the chances of renal disorders. Kidney failures, in these places, are thus borne out of dispossession and poverty to a large extent.

Chronic kidney diseases (CKD) entail conditions where the power of filtering and eliminating waste from the blood is reduced for over three months. Reduced protein and albumin leakage and renal filtration occur in CKD, which advances to give rise to end-stage kidney disorder (ESKD). Nephropathy is a phenomenon of inflation caused in the nephrons or filters or functional units in the kidneys. Populations are distinctive groups of individuals possessing similar traits. A community comprises a group of people with similar characteristics dwelling together in the same area. In Australia, kidney diseases are traced to be a prevalent health issue, where ESKD patients have low health outcomes. ESKD is associated with a high morbidity and mortality rate, along with poor life quality.

Detecting and treating the disease in its early stages would limit its course, lowering the social and financial costs levied on the population as well as the healthcare systems. Poor nutrition, diabetes, smoking and drinking are leading causes for consequent heart and kidney failures in Aboriginals, as outbreaks tend to occur in far remote areas (Hill et al., 2017).  Impact Of Kidney Diseases On Aboriginal Communities In Australia Essay Paper In chronic end-stage kidney diseases, people generally need a transplant or dialysis to survive. Many aboriginals choose dialysis as transplants cause hindrances in their daily lifestyles. The likelihood to be dying with kidney-related conditions is 15% more than that of Aboriginals (Davey,2021). The pyramid health shape prevalent in the community depicts how younger children have higher survival rates, along with few living grandparents amongst Aboriginals. Aboriginal mothers can also pass on kidney diseases to their children. Aboriginal babies have less than 400,000 nephrons as compared to 1 million. Patients also seek RRT or “renal replacement therapy” for longer-term survival. Kidney and urinary diseases made up for 1.4% of the complete disease burden in the year 2015.

Changes for the Community (highlighting role of a nurse)

Understanding Chronic Kidney Diseases

For chronic conditions, a nurse’s knowledge would help patients get an understanding of the severity of their state. Health profiling, along with capacity building programs for chronic diseases should be enhanced for indigenous services of health. The development of treatment and screening protocols should ensue, along with adaptations to various programs. Awareness heightens the spread of information in a community. The glomerulomegaly found in the Aboriginal environment have been traditionally low on birth rates, where a multiracial autopsy of renal ultrastructure is generated (Hoy et al., 2021).. It shows a lower number of nephrons and a larger glomerular volume in the kidneys. The propriety of giving medicines to patients living in these substandard environments, whose compliance and health behaviours tend to fall short of clinical expectations. The renal replacement therapy (RRT) rates in the remote Aboriginal community have been highly persistent while being associated with the socioeconomic status of people (Gorham et al., 2021). Optimal application of the therapy along with generous timelines of referrals influences survival rate of people. The notwithstanding nature of satellite units can curb this community to often accessing haemodialysis facilities for poverty and distance. Facts from the aboriginal sufferer’s database suggest how many patients have been practically and financially incapable of returning home (Conway et al., 2018). Additionally, the restricted count of dialysis machines also makes patients utilize planes for finding vacant ones.

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Improvement of access to medical interventions are necessary for the people in the Aboriginal community, to reduce the risks of dangerous diseases. This would be brought about by providing specialist training and education for treating Aboriginal people at par with non-aboriginal individuals. As compared to 45% in non-aboriginal Australians, only 12% aboriginals affected with EKSD are treated with a functional kidney transplant (Davey, 2021). Kidney transplantation generally offers the best rehabilitation at lower costs. But due to the absence of donors, dialysis is considered as the next suited alternative. It is usually a challenge to match up genetics. Patients should be getting dialysis around 3 times a week, every treatment lasting for over 3-4 hours. In this time, their blood is sucked out in a specific tube, cleaned, and reinserted into body in other tubes.

In order to increase better outcomes for Aboriginal people, the containment of RRT has great potential. As primary prevention involves many partners, management protocols remain at the brim of screening health services. Indigenous people are further getting trained in healthcare to efficiently embrace health service delivery. Attendance rates in hospitals are poor as it is deemed for Aboriginals to not be completely comfortable in a ‘western setting’. Aboriginal people are traumatised for their disorder, but additionally, face the hassles of having to travel long distances for attaining some form of quality treatment.

The Need For Early Detection And Intervention

A key area to raise awareness in the community would be through educating them sufficiently on comprehension of risk factors and consequences of kidney diseases, where preventative measures can be properly adapted. This vulnerable community would be targeted through messaging them in various languages, as per convenience. Preventative campaigns of health should be evaluated by the provision of clear access to information in the aboriginal community. It would focus on mandatory check-ups for individual assessment of unique needs. Renal nurses need to engage in monitoring RRT’s technical aspects, for effectively administering it for ESKD patients (Gallagher et al., 2017).

Nurses play a critical role in hospital-based or home-based dialysis. ESKD require assistance for gaining psychosocial support, in addition to fulfilment of medical needs. Nursing practices need to utilize a collaborative approach for Aboriginal community care. They take guidance from specialists, to further educate their patients regarding the nature of their disease, help them formulate choices of treatment, and adapt to several coping mechanisms. Interventions would yield success when the Aboriginal community is involved in the development of programs in their favour, in culturally appropriate ways.

Practical ways of assessing the kidney function level occurs through the calculation of the “glomerular filtration rate” (GFR), to measure the amount of waste filtered from the kidneys per minute (Gounden et al., 2018), It should be below 90 ml/min as per normal kidney functions. Caring for older patients with EKSD implies treatments carrying out their kidney functions. The Renal Association (2013b) can be referred for guidelines as to whether the patient should be sent to a nephrologist (Ashby et al., 2019). This would be easier to be accessed by the older community, saving them their time and effort if their condition is not entirely fatal. Patients having stage 5 CKD or above and a GFR below 10 are given dialysis, either peritoneal or haemodialysis. Conservative management can be applied for very old patients who consume medications to control symptoms at the last stage of their lives, assisted by a renal nurse. In the initial stages, water and toxin control can be managed through dietary restrictions. Depending on the severity of the condition, dietary advice can incorporate the intake of fluid, potassium, phosphate and calories.

Focused screening and prevention programs can be indicated for the older population, who have enhanced risks for the presence of morbidity factors (Jongen et al., 2017). These people can also have relatives with proteinuria or chronic kidney disorders, which are asymptomatic clinically but possess risks for cardiovascular disorders in future. Healthcare practitioners with the responsibility of dealing with CKD patients should be informed about stronger familial aggregation, and emphasize employing screening measures that can curb the progression of the disease.

Factors Influencing Kidney Diseases In The Aboriginal Community

The mediation of an action plan would help in executing reforms at the community and population levels. These plans inculcate detailed strategies for accomplishing more than one objective. The modification efficacy would be enhanced by formulating actions having targeted steps. As per principles of the Health Promotion Planning Cycle, evaluation of pertinent changes is necessary. Once the target group, as well as health conditions, are set, objectives would be deciphered for accomplishment (Hubley & Copeman, 2018).  The requirements of EKSD patients, along with the significance of changes have been analysed in Part A and Part B. The action plan would have the purpose of enhancing community knowledge regarding early detection and risk factors of end-stage kidney diseases. The older population can be assisted to participate in screening for the risk factors of ESKD. It can also help health experts to implement necessary adjustments at the level of the community and the population. The guidelines would direct professionals to put changes into actual practices.

Goal: 

The purpose of the plan is to improve health promotion at the level of the community and the population in Australia. The study would target the older population in the Aboriginal Community.

Objectives:

• To screen for the disease’s early detection and identification of the risk factors.
• To conduct awareness programs for educating the community.
• To create health-related nursing interventions to enhance patient outcomes.

Strategies: The target group needs to be chosen and precise information of clinical records should be collected. The local languages can be utilized for raising awareness through using messages and visual aids. Peer instructions, charts, radio can be adequately employed for educating, by utilization of social media to an extent. Small assessment tests should be carried out. Delivering dialysis into the remote aboriginal communities of Australia would require training the staff culturally, as they can need photographic instructions more profoundly than written guidelines (Hughes et al., 2018). Practitioners need to impart respect and not even take deceased names for their beliefs.

Partners: Healthcare professionals, multidisciplinary teams, nurse experts, healthcare teams.

Resources: The scarce availability of resources in the Aboriginal community imposes difficulty for improving community treatment conditions. However, nurses can be trained efficiently for the smooth conduction of control and intervention procedures.

Time: Up to three months would be required for the completion of this process.

Evaluation: Assessment results would be noted for noticing behavioural changes in Aboriginal people who become willing to seek remedy on the appearance of the slightest signs.

Outcome: Due to the high assessment scores, most individuals in the Aboriginal community are becoming self-aware and also attaining new skills.

Strategies: Technological interventions such as the utilization of cutting-edge procedures should be adopted for programs of awareness for older individuals. These would aim to configure deep-rooted sentiments through questionnaires. Public awareness initiatives can be created to fulfilling the requirement of early detection (Porter et al., 2017). Healthcare staff need to have sufficient knowledge about campaigns. The establishment of a well-equipped infrastructure and facility can allow early disease identification. Nursing practices should observe no forms of bias against the elderly. Their needs should be efficiently catered to, while hearing their issues out intently. Surveys can be conducted at the onset and at the decrease of the disorder in the older population to achieve essential differences.

Role Of Nurses In Managing Kidney Diseases In Aboriginal Community

Partners: Multidisciplinary teams, health and nurse experts.

Resources: The time of dialysis would require ensuring safety protocols and safe handling of the old patients. They should be assisted with movement, given dietary plans. Nurses should utilize equipment to assist affected patients with urination through catheters. Awareness can be provided after the health betterment of the elderly people.

Time: The interval for promoting health standards among old Aboriginal people would be 5 months.

Evaluation: The physical parameters of the affected patients would be checked such as hypertension, blood pressure, temperature and comfort. Recovery patterns can be traced through their overall attitude in their lifestyle. Surveys can be generated to assess their health status.

Outcome: The frequency of the issues related to end-stage kidney diseases faced by the older population in the Aboriginal community has been decreasing.

References

Ashby, D., Borman, N., Burton, J., Corbett, R., Davenport, A., Farrington, K., … & Wilkie, M. (2019). Renal association clinical practice guideline on haemodialysis. BMC nephrology, 20(1), 1-36. https://doi.org/10.1186/s12882-019-1527-3

Conway, J., Lawn, S., Crail, S., & McDonald, S. (2018). Indigenous patient experiences of returning to country: a qualitative evaluation on the country health SA Dialysis bus. BMC health services research, 18(1), 1-13. https://doi.org/10.1186/s12913-018-3849-4

Davey, R. X. (2021). Health Disparities among Australia’s Remote-Dwelling Aboriginal People: A Report from 2020. The Journal of Applied Laboratory Medicine, 6(1), 125-141. https://doi.org/10.1093/jalm/jfaa182

Gallagher, H., Methven, S., Casula, A., Thomas, N., Tomson, C. R., Caskey, F. J., … & Nation, M. (2017). A programme to spread eGFR graph surveillance for the early identification, support and treatment of people with progressive chronic kidney disease (ASSIST-CKD): protocol for the stepped wedge implementation and evaluation of an intervention to reduce late presentation for renal replacement therapy. BMC nephrology, 18(1), 1-10. https://doi.org/10.1186/s12882-017-0522-9

Gorham, G., Howard, K., Cunningham, J., Barzi, F., Lawton, P. and Cass, A., 2021. Do remote dialysis services really cost more? An economic analysis of hospital and dialysis modality costs associated with dialysis services in urban, rural and remote settings. BMC health services research, 21(1), pp.1-14. https://doi.org/10.1186/s12913-021-06612-z

Gounden, V., Bhatt, H., & Jialal, I. (2018). Renal function tests.

Hill, K., Ward, P., Grace, B. S., & Gleadle, J. (2017). Social disparities in the prevalence of diabetes in Australia and in the development of end stage renal disease due to diabetes for Aboriginal and Torres Strait Islanders in Australia and Maori and Pacific Islanders in New Zealand. BMC Public Health, 17(1), 1-8.

https://doi.org/10.1186/s12889-017-4807-5

Hoy, W. E., Swanson, C. E., & Mott, S. A. (2021). Birthweight and the prevalence, progression, and incidence of CKD in a multideterminant model in a high-risk Australian Aboriginal community. Kidney international reports, 6(11), 2782-2793. https://doi.org/10.1016/j.ekir.2021.08.010

Hubley, J., & Copeman, J. (2018). Practical health promotion. John Wiley & Sons.

Hughes, J. T., Dembski, L., Kerrigan, V., Majoni, S. W., Lawton, P. D., & Cass, A. (2018). Gathering Perspectives?Finding Solutions for Chronic and End Stage Kidney Disease. Nephrology, 23, 5-13.

Jongen, C. S., McCalman, J., & Bainbridge, R. G. (2017). The implementation and evaluation of health promotion services and programs to improve cultural competency: a systematic scoping review. Frontiers in public health, 5, 24. https://doi.org/10.3389/fpubh.2017.00024

Porter, L., Matunga, H., Viswanathan, L., Patrick, L., Walker, R., Sandercock, L., … & Jojola, T. (2017). Indigenous planning: From principles to practice/a revolutionary pedagogy of/for indigenous planning/settler-indigenous relationships as liminal spaces in planning education and practice/indigenist planning/what is the work of non-indigenous people in the service of a decolonizing agenda?/supporting indigenous planning in the city/film as a catalyst for indigenous community development/being ourselves and seeing ourselves in the city: Enabling the conceptual space for indigenous urban planning …. Planning Theory & Practice, 18(4), 639-666. https://doi.org/10.1080/14649357.2017.1380961

Thomson, R. J., McMorran, B., Hoy, W., Jose, M., Whittock, L., Thornton, T., … & Foote, S. (2019). New genetic loci associated with chronic kidney disease in an indigenous Australian population. Frontiers in genetics, 10, 330. https://doi.org/10.3389/fgene.2019.00330 .  Impact Of Kidney Diseases On Aboriginal Communities In Australia Essay Paper