Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation

BMC Nephrol. 2018 Jan 10;19(1):5. doi: 10.1186/s12882-017-0800-6.

Abstract

Background: Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States.

Methods: This is a mixed methods study that uses both deductive and inductive qualitative analysis of a dialysis staff survey conducted in 2012 using three open-ended questions that asked staff to discuss their perceptions of factors that may contribute to transplant disparities among African American, female, and elderly patients.

Results: Study results suggested that the majority of staff (n = 255, 28%) perceived patients' low socioeconomic status as the primary theme related to why renal transplant disparities exist between African Americans and non-Hispanic whites. Staff cited patient perception of old age as a primary contributor (n = 188, 23%) to the disparity between young and elderly patients. The dialysis staff responses on gender transplant disparities suggested that staff were unaware of differences due to limited experience and observation (n = 76, 14.7%) of gender disparities.

Conclusions: These findings suggest that dialysis facilities should educate staff on existing renal transplantation disparities, particularly gender disparities, and collaboratively work with transplant facilities to develop strategies to actively address modifiable patient barriers for transplant.

Keywords: Barriers; Dialysis; End stage renal diseases; Kidney transplant; South.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Attitude of Health Personnel*
  • Continental Population Groups / ethnology*
  • Cross-Sectional Studies
  • Female
  • Health Personnel / trends
  • Health Services Accessibility / trends
  • Healthcare Disparities / trends*
  • Humans
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation / trends*
  • Male
  • Middle Aged
  • Renal Dialysis / trends*
  • Sex Factors