Perceptions of Hispanic Patients with Advanced CKD About Communication and Engagement Regarding Kidney...

Access to kidney transplantation (KT) for Hispanic patients with advanced chronic kidney disease (CKD) is often attributed to spoken languages different from their healthcare providers. Effective communication, however, is not limited to language, and involves consideration of social context and background; and if successful, can lead to better engagement. Understanding patients' perspectives on the communication and engagement with their providers regarding KT may inform clinical practice and this was the objective of this study.

Cross-sectional qualitative study SETTING & PARTICIPANTS: Hispanic individuals with advanced CKD who identified Spanish as their primary language.

Bilingual staff conducted 1:1 semi-structured interviews using a guide based on published literature on healthcare disparities. Berlo's Communication Framework was used to guide analysis of the interviews.

Twenty participants from five states (age 57±11 years, 50% female) were interviewed; 18 were receiving maintenance dialysis, and 11 had diabetes. Participants reported that communication regarding eligibility for KT and the KT process was insufficient to make an informed decision, especially when the information was provided outside of transplant clinic setting. During the discussions for treatment options with their clinical providers, participants experienced inadequate consideration of their socioemotional well-being. Participants often felt that healthcare providers did not provide sufficient information. While discordance in spoken language between patients and clinicians was a barrier, it was largely mitigated by interpreters.

Lack of representation from all parts of the country.

This study identified several areas of suboptimal patient-provider communication and patient engagement for Hispanic patients with advanced CKD. These findings may inform strategies to improve communication and patient engagement, thereby addressing barriers to accessing KT for Hispanic patients.