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The Impact of Lack of Awareness on Care Outcomes



Several studies document the vital nature of awareness in the outcomes of patient care. Scholars, such as Polit and Beck (2008), call for increased awareness of renal care among diabetic patients from early diagnosis too late referral stages.

The authors emphasize that poor access to knowledge of diabetes-related renal complications until patients go for referral services is worrying. Previous literature documents the main reasons for patients’ limited awareness about the impacts of the disease as lack of knowledge, poor discussions with clinicians, and the silent nature of renal diseases. For some, this lack of awareness begins with the early diagnosis since; they focus more on doctor-patient interactions and not on advice. To acquire in-depth information on the impact of this lack of awareness among patients, Wilkinson et al. (2011) conducted a cross-cultural study of South Asians and indigenous Europeans.

Background to the study

Previous studies show that awareness of renal complications associated with diabetes has direct links with a referral for renal services. Wilkinson et al. (2011) investigated the relevance and effectiveness of information on services meant to improve care outcomes for patients with diabetes and renal failure. Combining evidence-based research and interviews aided in investigating cross-cultural differences among the study group at strategic points of care. This study sought to affirm that care centers should analyze information exchange to discuss present cultural differences.


Wilkinson et al. (2011) used qualitative research to investigate the impact of patients’ limited awareness on care outcomes. The exploratory study allowed the researcher to understand the sample population and to gain in-depth knowledge of the study’s main aim. The semi-structured qualitative study recruited participants from three centers in the United Kingdom (UK). The participants have newly-referred diabetes patients from Luton, Leicester, and West London. Specialists from the nephrology departments of the three centers assisted in ensuring that patients meet the study’s inclusion criteria. The study sample included 48 participants of both South Asian and indigenous European origins with experience of access at referrals.

Using the findings in nursing practice

Findings from earlier studies conducted within the UK show that poor quality healthcare, as well as compliance among South Asians, increases the likelihood of late-stage renal failure patients acquiring diabetes (Burns & Grove, 2011). However, research has given little attention to reducing inequity in patient outcomes for culturally diverse patients such as South Asians with late-stage renal disease. Still, researchers have observed differences in attaining culturally competent services for patients treating late-stage renal diseases.

This literature gap motivated Wilkinson et al. (2011) to conduct a cross-cultural comparative study of South Asian patients with indigenous Europeans. Most importantly, this study examined the perception of quality care access among South Asians. While awareness also links to recent monitoring, findings of this study show that it does not relate to past medical encounters. This study affirms that increasing awareness for disease complications has significant value in improving point of care outcomes.

Ethical considerations

Ethics are principle systems, which consider right and wrong in decision-making. Any research inquiry has to consider values of practice, the community, and people taking part in the study. Wilkinson et al. (2011) addressed the emerging ethical issues by first seeking the approval of the Local Research Ethics Committee before commencing recruitment. The ethics review included recruitment documents, consent forms, invitation letters, and information sheets on the patients’ decisions. The review made sure that the research followed the concepts of anonymity and confidentiality, obtaining informed consent, and keeping individual privacy.

This peer-reviewed research protected the participant’s privacy and explored all the ethical considerations to make sure that they did not violate the values of the participants. The researchers received either written or verbal consent before commencing the interview. To preserve the anonymity of the participants, the researcher did not include participants’ names in the transcripts but allocated codes. The research handled ethical concerns and conflicting values that emerged recurrently with the literature review. The researcher hired bilingual researchers to answer questions from South Asians who may lack good command of English.


Evidence from this study indicates that most South Asians embrace neither diabetes services nor follow-up later renal care appointments in hospitals. Among the participants, South Asian patients had increased access to knowledge of the high prevalence rates of diabetes, especially within their communities. However, language barriers were key contributors to limited information among South Asian communities.

This study also affirms that while family members of the two cultures may have had previous experiences with kidney problems, this may not have a direct link to diabetes. This study emphasizes that access to information has relevance in improving point of care outcomes among diabetes and renal failure patients. Although the sample size was broadly representative of the target population, Wilkinson et al. (2011) wanted to improve the study sample by including nurses. However, this could not be completed, because the Research Ethics Committee failed to give feedback in due time. Including nurses, in future research, could add valuable insights into this study.


Burns, N., & Grove, S. (2011). Understanding nursing research: Building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier.

Polit, D. F., & Beck, C. T. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Philadelphia, US: Lippincott Williams & Wilkins.

Wilkinson E. et al. (2011). Lack of awareness of kidney complications despite familiarity with diabetes: A multi-ethnic qualitative study. Journal of Renal Care, 37(1), 2-11.

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