Critical Public Health · Available online 19 Jun 2026 · In press · DOI 10.1080/09581596.2026.2687197
Melissa Arnold-Ujvari, Elizabeth Rix, Kim O’Donnell, Janet Kelly
Introduction Culturally responsive family and kinship-focused care is crucial for equity and inclusion of Aboriginal and Torres Strait Islander People in public health and healthcare settings. In Australia, a predominantly non-Aboriginal nursing workforce delivers healthcare, and the lack of understanding of the importance of family, community, and Country can inadvertently cause negative consequences daily. This study investigated renal nurses’ cultural education in metropolitan and rural health services in South Australia and how this translated into their clinical practice when caring for Aboriginal and Torres Strait Islander People with kidney disease.Theory The study is informed by Indigenous Institutional Theory and utilises various theories, concepts, approaches, and frameworks that focus on culturally responsive care, decolonisation, and institutional racism. These frameworks help to understand the challenges and barriers faced by both Aboriginal and Torres Strait Islander and non-Aboriginal nurses in delivering culturally safe care.Method A qualitative Participatory Action Research study was conducted using semi-structured interviews as part of a larger collaborative project. The methods included thematic analysis of interview data, engaging with participants to share their cultural education journeys and implementation of cultural care into practice, and discussing findings with the AKction Aboriginal and Torres Strait Islander consumer reference team for decolonising contextual verification.Results The study uncovered significant frustrations among both Aboriginal and Torres Strait Islander and non-Aboriginal nurses regarding the lack of access to cultural education and the presence of institutional barriers to improving cultural safety skills and practices. Five illustrative themes were identified, using participant direct quotes as headings, such as “It’s given me confidence to approach tricky conversations” and “Our Presence [Aboriginal and Torres Strait Islander staff] does not absolve you of being a culturally safe clinician.”Discussion The discussion highlighted that despite strong individual goodwill, organisational inertia driven by institutional racism and lack of motivation hinder the prioritisation of cultural education and the implementation of culturally safe kidney care for Aboriginal and Torres Strait Islander People. Comparisons with other studies suggest similar patterns, and further research is necessary to develop effective strategies for overcoming these barriers. Recommendations include increasing access to cultural education, addressing institutional racism, and implementing policies to support culturally safe clinical practices.
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Arnold-Ujvari, M., Rix, E., O’Donnell, K., et al. (2026). From cultural education to culturally safe kidney care: renal nurses’ experiences caring for Aboriginal and Torres Strait Islander peoples in South Australia. Critical Public Health. https://doi.org/10.1080/09581596.2026.2687197