For American Indians and Alaska Natives (AI/AN, there is a dire need for kidney transplantation as a consequence of the pervasiveness of type 2 diabetes. Unfortunately, there are few AI/AN donors each year. The purpose of this study was to discover the sociocultural patterns that influence intentions and decisions about organ and tissue donation among American Indian adults. The qualitative ethnographic study used a social-ecological framework derived from the discipline of public health. The snowball sample included 21 Oglala Lakota Sioux adult men and women (age >19 years). Person to person interviews were conducted using structured open-ended questions derived from the organ donation literature and from the social-ecological framework. Interviews were audiotape and professionally transcribed. Data were categorized into construct codes using analysis of emerging themes. The themes that emerged from the analysis included uncertain knowledge, the diabetes crisis, cultural transitions, health care system competence, and outreach efforts. Participants knew very little about the organ and tissue donation process. There was a basic understanding of donor and recipient compatibility. Testimony that diabetes is contributing to a dire need for kidney donors among Indian people was pervasive. Participants knew people who were on dialysis or who were waiting for a kidney donor. Traditional beliefs about entering the spirit world with an intact body were cited. Bridging traditional beliefs and values with the diabetes crisis was viewed as essential. Participant trust in the health care system and the readiness of the IHS hospitals for organ and tissue donation was a concern. Culturally-competent educational outreach programs tailored to the reservation community need to include system change in leaders, health care provider competence, use of community stories and respect for family communication.
Session #1209 - Cultural Meaning & Health & Illness
The 29th Annual MNRS Research Conference (April 1-4, 2005)