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Title: The YinYang Balance of Healing: A Qualitative Study of Barriers to Living Kidney Donor Transplantation in Chinese-Canadians
Authors: Li, J., Yang, C., Zhang, X., Quach, H., Kang., J., Edwards, B., Mucsi., I.
Year: 2021
Conference: CST, SURP
Full Abstract* Background: Chinese-Canadians have increased risk of kidney failure and are substantially less likely to receive living donor kidney transplant (LDKT), compared to Whites. Research suggests that potentially conflicting health beliefs, values, and practices between Western and Traditional Chinese Medicine (TCM) may contribute to barriers limiting willingness of Chinese-Canadians to consider LDKT. Purpose: In this analysis we use qualitative data from a mixed-methods study seeking to understand barriers to LDKT among Chinese-Canadians. Methods: Purposive and snowball sampling were used to recruit Chinese-Canadian patients and community partners to participate in semi-structured interviews conducted over the phone/ MS Teams in the participant’s preferred language(s) (English, Mandarin/Cantonese). Open-ended questions were asked about transplant-related knowledge, attitudes towards kidney transplantation, and cultural factors. Audio was recorded, transcribed, and analyzed via thematic analysis using inductive and deductive development of codes, categories, and themes. Results: Six participants (1 LDKT recipient, 1 live-kidney donor, 4 participants without kidney failure experience; 3 females) were interviewed and described cultural and contextual factors influencing their views and experiences of LDKT. Conflicting values between TCM and Western medicine is emerging as a major theme. Identified sub-themes include importance of integrity of both kidneys for overall well-being of the individual. This may induce concerns about donating one kidney, in spite of its very low risk from a Western, physiological point of view. Participants also expressed preference for non-invasive traditional herbal remedies. Our interviews suggest that experience with kidney disease/failure and with the Canadian healthcare system may increase acceptance of Western medical practices over TCM. Conclusion: In this preliminary analysis we found that TCM values and practices (e.g. emphasis on balance, use of herbal remedies) may influence attitudes of Chinese-Canadians towards LDKT and live kidney donation. Culturally tailored, comprehensive information about kidney disease and kidney failure treatment options may improve access to LDKT for Chinese-Canadians.
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