DR SAJITH KESAVAN NAYAR, DR SOPHIE PASCOE, ASSOCIATE PROFESSOR GILLIAN GORHAM, DR SAJIV CHERIAN, PROFESSOR ALAN CASS, PROFESSOR OYELOLA ADEGBOYE2, Cheryl Ross2, TRUDI SIENDLAND2
1Alice Springs Hospital, Alice Springs, Australia, 2Menzies School of Health Research, ,
Biography:
Dr Sajith Nayar is a Consultant Nephrologist at Alice Springs Hospital with over 10 years of experience working with First Nations patients in Central Australia. His clinical and research focus is on improving health outcomes for Aboriginal and Torres Strait Islander peoples affected by kidney disease. Dr Nayar is actively engaged in research undergoing PhD and co-design initiatives aimed at enhancing dialysis access, cultural safety, and patient-centred care in remote settings.
Aim:
To explore the modifiable factors affecting dialysis attendance among First Nations patients in Central Australia and co-design culturally responsive pathway to improve their treatment journey.
Background:
First Nations Australians in remote Central NT communities experience a disproportionately high burden of kidney disease, often requiring relocation to regional centres for dialysis. This disrupts family, community, and cultural connections and contributes to inconsistent treatment attendance and poorer health outcomes.
Methods:
A qualitative study using Yarning Circles and semistructured interviews was conducted across Alice Springs and the Barkly region. Participants included dialysis patients, First Nations mentors, health workers, social workers, transport staff, and clinicians. Over 30 interviews and multiple group discussions were thematically analysed.
Results:
Key themes influencing attendance included: disconnection from family and Country due to dislocation and the remoteness to treatment were linked to lower attendance and higher emergency department presentations. Reasons often are related to cultural and family obligations. The lack of cultural safety, communication barriers with clinical staff, limited resources and rigid treatment schedules also contributes to low attendence. Participants expressed a strong desire for holistic and community-embedded models of care. Younger age patients also feel shameful and embarrassed to undergo dilaysis requiring emotional support. Social determinants such as housing instability and transport challenges also contributes to low attendance.
Conclusion:
Improving dialysis attendance requires a multifaceted response. Services must be flexible, culturally respectful, and adequately resourced. Strategies should include enhanced cultural competency training, better integration of First Nations health navigators, community based dialysis options, adequate housing support, and psychosocial care tailored to patients’ lived realities. Empowering patients and families through, culturally grounded models can improve engagement and outcomes in First Nations dialysis patients.