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The Emergence of Cultural Safety Considerations within Kidney Care in Australia
for First Nations People

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M. Arnold-Ujvari, J. Kelly, and E. Rix 1
Adelaide Nursing School, University of Adelaide, Australia
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Background: Until the late 1990s, cultural considerations have been absent in kidney care provision for
First Nations People. Culture was viewed as a hindrance, leading to negative outcomes. It was not until
2010 that cultural safety elements were considered within renal literature in Australia.

Objective: Identify the emergence of cultural safety considerations within Australian kidney care of
First Nations People.

Methods: A systematic review of all literature was conducted with a specific focus on cultural models
of care. Inclusion criteria were First Nations People with kidney failure in Australia and health
professionals, published in English between January 1998 and May 2022. Multiple databases searched,
findings synthesised and presented in thematic form and a timeline developed.
Oral Presentation Abstracts
Results: The importance of Country, kinship and communication were key themes throughout the
timeline. The timeline also identifies the persisting negative lens of ‘non-compliance’, the emerging
recognition of health and well-being benefits of cultural practices, the need for critical reflection,
and cultural safety training and acknowledgement of the negative impacts of unconscious bias and
institutional racism.

Conclusion: This review highlights the importance of a more open and caring approach towards
First Nations patients and their families, where staff are increasingly culturally responsive, emotionally
intelligent, and critically reflective. Striving towards a deeper understanding of how attitudes and
prejudices can positively impact on care provision.

Cultural safety is a lifelong journey, involving inclusive and collaborative decision making in patients’
own health journeys and kidney care, through active listening and acting upon their needs. Alongside
evaluation of staff and services to assess provision of culturally safe and responsive care.

Keywords: First Nations, cultural safety, kidney care

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Correspondence: Melissa Arnold-Ujvari, Adelaide Nursing School, University of Adelaide, Australia
E-mail: melissa.arnold-ujvari@adelaide.edu.au

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