“All they said was my kidneys were dead”: Indigenous Australian patients’ understanding of their chronic kidney disease

Kate Anderson, Jeannie Devitt, Joan Cunningham, Cilla Preece and Alan Cass
Med J Aust 2008; 189 (9): 499-503.
  • Kate Anderson1
  • Jeannie Devitt1,2
  • Joan Cunningham3,4
  • Cilla Preece5
  • Alan Cass1,6

  • 1 The George Institute for International Health, Sydney, NSW.
  • 2 Cooperative Research Centre for Aboriginal Health, Darwin, NT.
  • 3 Menzies School of Health Research, Darwin, NT.
  • 4 Institute of Advanced Studies, Charles Darwin University, Darwin, NT.
  • 5 Cairns Diabetes Centre, Queensland Department of Health, Cairns, QLD.
  • 6 Faculty of Medicine, University of Sydney, Sydney, NSW.



We gratefully acknowledge the support of the study participants, participating treatment sites and their associated reference groups. We also thank the participating Aboriginal community-controlled health services. This study was undertaken as part of the IMPAKT Study, funded by the National Health and Medical Research Council (NHMRC), Project Grant No. 236204. Alan Cass was supported by an NHMRC Senior Research Fellowship (No. 457101). Kate Anderson was partially funded through an Australian Postgraduate Research Scholarship. Joan Cunningham was supported by an NHMRC Career Development Award (No. 283310). Through endorsement as an “in-kind” project, IMPAKT was supported by the Co-operative Research Centre for Aboriginal Health (CRCAH), Darwin, to provide participant feedback, to fund NVivo training (Cilla Preece), and institutional support (Jeannie Devitt). The Menzies School of Health Research funded NVivo training (Jeannie Devitt). The NHMRC, CRCAH and Menzies School had no role in study design, data collection, analysis or interpretation, or in writing of the article. They had no control or influence in the decision to submit the final manuscript for publication. We thank Dr Peter Arnold for assistance with preparing this article.

Competing interests:

None identified.

  • 1. Cass A, Cunningham J, Snelling P, et al. Renal transplantation for Indigenous Australians: identifying the barriers to equitable access. Ethn Health 2003; 8: 111-119.
  • 2. Pound P, Britten N, Morgan M, et al. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med 2005; 61: 133-155.
  • 3. Krespi R, Bone M, Ahmad R, et al. Haemodialysis patients’ beliefs about renal failure and its treatment. Patient Educ Couns 2004; 53: 189-196.
  • 4. Lawton J, Ahmad N, Peel E, Hallowell N. Contextualising accounts of illness: notions of responsibility and blame in white and South Asian respondents’ accounts of diabetes causation. Sociol Health Illn 2007; 29: 891-906.
  • 5. Parry O, Peel E, Douglas M, Lawton J. Issues of cause and control in patient accounts of type 2 diabetes. Health Educ Res 2006; 21: 97-107.
  • 6. Witenberg SH, Blanchard EB, Suls J, et al. Perceptions of control and causality as predictors of compliance and coping in hemodialysis. Basic Appl Soc Psych 1983; 4: 319-336.
  • 7. Cass A, Cunningham J, Snelling P, et al. Exploring the pathways leading from disadvantage to end-stage renal disease for Indigenous Australians. Soc Sci Med 2004; 58: 767-785.
  • 8. Cass A, Lowell A, Christie M, et al. Sharing the true stories: improving communication between Aboriginal patients and healthcare workers. Med J Aust 2002; 176: 466-470. <MJA full text>
  • 9. Devitt J, Cass A, Cunningham J, et al. Study protocol — Improving Access to Kidney Transplants (IMPAKT): a detailed account of a qualitative study investigating barriers to transplant for Australian Indigenous people with end-stage kidney disease. BMC Health Serv Res 2008; 8: 31.
  • 10. Warnecke RB, Johnson TP, Chavez N, et al. Improving question wording in surveys of culturally diverse populations. Ann Epidemiol 1997; 7: 334-342.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.