The Emotional Experience of American Indians Receiving Hemodialysis and How It Relates to Treatment Adherence

This study used a phenomenological approach as an attempt to capture the essence of the experience of American Indians with diabetes who are receiving dialysis. The purpose of this study and this approach was to develop an understanding of factors that influence treatment adherence, specifically with mental health concerns. As an additional component of this study, this research also followed an advocacy/participatory approach (Creswell, 2007) in which steps to reform services are provided to the Indian Health Service in support of this marginalized group through a written Agenda for Change. Participants for this study were recruited from multiple states serving American Indians through the Indian Health Service. These sites were specifically located within the states of Oklahoma, Kansas, Iowa, Nebraska and South Dakota. Fliers were posted at dialysis clinics, post offices, general stores and community centers in which there where high American Indian populations. Participants initiated contact and were screened for meeting criteria to participate in the study. After three months with fliers posted in multiple locations, the recruitment concluded with six participants (three women and three men). The experience described by the participants was utilized to recommend a change in processes for dialysis patients in an effort to assist with acceptance for individuals and families as they adjust to the lifetime commitment and changes required by dialysis treatments. Advisor: Michael J. Schee