Shifting Life's Focus: African American Dialysis Patients' Experiences with Kidney Transplant Evaluation

Abstract

Chronic Kidney disease is a growing health problem, in the United States, disproportionately affects African Americans. Although African Americans have a significantly higher incidence of kidney disease and end stage kidney failure than Caucasian Americans, they are less likely to receive a kidney transplant. This study begins to build a substantive theory about patients' experiences with the kidney transplant evaluation process to better understand this health disparity. Participants in this study were interviewed in the dialysis unit about these experiences. Shifting Life's Focus, the substantive theory emerging from this study, explains participants' experience with the process of kidney transplant evaluation as they physically and emotionally prepared to receive a kidney transplant. Three major concepts compose this theory: complex chronic health issues, financial concerns, and following through. This theory not only explains the experiences of these participants, but may help explain those of other African American patients on dialysis. Understanding this theory may provide insight to reasons why many African Americans may complete their transplant evaluations and be listed to receive a kidney transplant and therefore has direct application to both health policy and clinical practice.