Undocumented immigrants are barred from all Medicare health care coverage and the Patient Protection and Affordable Care Act marketplace exchange plans. 5 - 7 People with undocumented US citizenship status (ie, people who entered the US without proper documentation) are primarily Latinx and face additional challenges. 4 Latinx individuals with kidney failure face a disproportionate burden of social challenges, including poverty, lower levels of education, and limited English proficiency. 1 Compared with non-Latinx White individuals, Latinx individuals are less likely to receive predialysis nephrology care 2 or a living donor kidney transplant 3 or be treated with home dialysis therapies. Latinx individuals experience a 2.1-fold greater incidence of kidney failure than non-Latinx White individuals and face structural racism and discrimination that contribute to kidney health disparities. The findings suggest that a peer support group may be a patient-centered strategy to build camaraderie and provide emotional support in kidney failure, especially for socially marginalized uninsured populations who report limited English proficiency. From interviews and meetings, 3 themes, with associated subthemes, were identified: camaraderie and emotional support from peers (subthemes: peer support is vital for people newly diagnosed with kidney failure, safe space to build relationships and share hardship with peers, hospital setting for peer support is ideal, solidarity to survive and change policy, and sustainability of the peer support group), solutions to improve care and resilience (subthemes: self-advocacy, self-motivation and optimism, kidney disease education, emotional support from peers caregivers, and faith), and emotional and physical aspects of receiving emergency dialysis (subthemes: psychosocial and physical distress, mixed experiences with language-concordant care, emotional exhaustion from end-of-life conversations, and gratitude for clinicians).Ĭonclusions and relevance This study found that peer support group intervention achieved feasibility and acceptability. Among them, 5 individuals withdrew and did not attend meetings and 18 participants (retention rate, 78.3%) attended a mean of 6 of 12 meetings (50.0%). Results Of 27 undocumented immigrants with kidney failure receiving emergency dialysis, 23 participants (9 females and 14 males mean age, 47 years) agreed to participate (recruitment rate, 85.2%). To assess the value of the peer support group intervention, themes and subthemes were identified from interviews with participants and group meetings. To measure acceptability, interviews were conducted with participants using a structured format. Main outcomes and measures To assess feasibility, the recruitment, retention, implementation, and delivery for the intervention were tracked. Data were analyzed from March to June 2022. The 6-month intervention included peer support group meetings in the hospital while participants were hospitalized for emergency dialysis. Objective To investigate the feasibility and acceptability of a single-group peer support group intervention.ĭesign, setting, and participants This qualitative and single-group prospective study for undocumented immigrants with kidney failure receiving emergency dialysis was conducted in Denver, Colorado, from December 2017 to July 2018. Culturally and language-concordant peer support group interventions may be associated with reduced depression and anxiety and may provide emotional support. Importance Most undocumented immigrants with kidney failure rely on emergency dialysis (defined as dialysis after a patient presents as critically ill) and experience significant depression and anxiety and high mortality. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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