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Remote Aboriginal communities in Canada struggle with the impact of end-stage kidney disease (ESKD). Hemodialysis (HD) is the most common modality for renal replacement therapy, which often necessitates moving to urban centres. This investigation describes the illness experience of Cree from the Mushkegowuk Territory with ESKD who received HD in Kingston, Ontario and, explores the impact of relocation on their perceived quality of life (QoL). A qualitative case study approach obtained the perspectives of 4 Cree HD patients; 3 nephrologists; 3 nephrology nurses; and 3 Weeneebayko Patient Service workers. The complexity of the Cree illness experience regarding HD treatment in an urban centre included: the illness experience of the Cree HD patients consisting of an acute and a chronic phase, divergence of health beliefs which affected the clinical interactions between patients and healthcare providers, and the social and cultural isolation due to relocating for HD which reduced the perceived QoL of Cree patients. The findings are presented in models co-created with the Cree patients. Satellite renal care programs located in rural and remote Aboriginal communities may significantly improve the QoL of this population as they can adapt to their condition within a familiar cultural context. [ABSTRACT FROM AUTHOR]

Using a qualitative approach, this study explored the perceptions of individuals with end stage renal disease (ESRD) regarding their physical, emotional, and social well-being after having participated in an eight-week hospital-based intra-dialytic exercise program. Individual semi-structured interviews (∼60 min. duration) were conducted with hemodialysis (HD) patients (n=7) during their regular dialysis sessions, two weeks immediately following the completion of the exercise program. Interviews were audio-taped, transcribed verbatim, and content analysis was used to identify emerging themes. Data management was assisted by NVivo software. Using the interpretive paradigm, three primary themes emerged: improved performance in activities of daily living (ADL), positive change in HD experience, and enhanced sense of control. Participants reported an overall positive experience with the intra-dialytic exercise program and felt that their quality of life was enhanced to such an extent that they would choose to continue exercising while on HD. [ABSTRACT FROM AUTHOR]