South Asian (SA) Canadians with kidney failure have a 50%-77% lower likelihood of kidney transplant and are less likely to identify potential living donors (LDs). This study aimed to identify health system–, patient-, and community-level barriers and facilitators for accessing LD kidney transplantation in the SA community to inform the development of health system– and community-level interventions to address barriers. Qualitative study. 20 SA recipients of an LD or deceased-donor kidney transplant, 10 SA LDs, and 41 general SA community members. In-depth multilingual interviews were conducted with recipients and LDs. Gender-, language-, and age-stratified focus groups were conducted with general SA community members. Summative content analysis was used to analyze the data. Hesitancy in approaching potential donors, fear about the health of potential LDs, information gaps, language barriers, and challenges evaluating out-of-country donors were highlighted as significant barriers by recipients, and financial concerns and information gaps were identified by donors. Cultural barriers in the SA community were highlighted by donors, recipients, and community members as critical factors when considering donation and transplant; women and elderly SA Canadians highlighted nuanced challenges. Participants reported generally a favorable perception of their health care teams, citing SA representation in the teams as important to providing culturally and linguistically sensitive care. Limited geographic, race, and cultural representation and reliance on virtual data collection. This study highlights several culturally relevant barriers to donation and transplant that are potentially modifiable through patient-, health system–, and community-focused engagement and education.

中文翻译：

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引导南亚裔加拿大人进行活体肾脏捐赠和移植：ACTION 项目

患有肾衰竭的南亚 (SA) 加拿大人进行肾移植的可能性降低 50%-77%，并且不太可能找到潜在的活体捐赠者 (LD)。本研究旨在确定南澳社区进行 LD 肾移植的卫生系统、患者和社区层面的障碍和促进因素，为制定卫生系统和社区层面的干预措施以解决障碍提供信息。定性研究。 20 名 LD 或已故捐赠者肾移植的 SA 受者、10 名 SA LD 和 41 名一般 SA 社区成员。对受助者和 LD 进行了深入的多语言访谈。与一般 SA 社区成员一起进行了按性别、语言和年龄分层的焦点小组。使用总结性内容分析来分析数据。接受者强调，在接触潜在捐助者时犹豫不决、对潜在 LD 健康状况的担忧、信息差距、语言障碍以及评估国外捐助者的挑战是重大障碍，捐助者还指出了财务问题和信息差距。捐赠者、接受者和社区成员强调南澳社区的文化障碍是考虑捐赠和移植时的关键因素；妇女和南澳老年加拿大人强调了微妙的挑战。参与者普遍对他们的医疗保健团队有良好的看法，并指出团队中的南澳代表对于提供文化和语言敏感的护理非常重要。有限的地理、种族和文化代表性以及对虚拟数据收集的依赖。这项研究强调了捐赠和移植方面的几个与文化相关的障碍，这些障碍可以通过以患者、卫生系统和社区为中心的参与和教育来改变。