“A politics of what” : A praxiography of renal disease in Indigenous renal patients

McCarthy, Alexandra & Martin-McDonald, Kristine (2006) “A politics of what” : A praxiography of renal disease in Indigenous renal patients. International Journal of Qualitative Methods, 5(3), p. 51.

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The morbidity and mortality rates of renal disease in Indigenous Australians are significantly higher than those of non-Indigenous Australians, and are increasing. The dominant discourses of renal disease currently predicate this as essentially a client problem, rather than (for example) a health care system problem. These discourses are indicative of the dominant “white” paradigm of health care, which fosters an expectation of assimilation by the marginalised “other.”

In this paper, we draw upon a sociological methodology (the actor network approach) and a qualitative method (discourse analysis) to tease out these issues in Indigenous renal disease. Based on empirical data, we explore on the one hand the requirements of the discourses, technologies and practices that have been developed for a particular type of renal patient and health system in Australia. On the other, we examine the cultural and practical specificities entailed in the performance of these technologies and practices in the Indigenous Australian context.

The meeting of the praxiographic orientation of the actor network approach—which has been called “the politics of what” (Mol 2002)—and the sociocultural concerns of discourse analysis does provide a useful guide as to “what to do” when confronted with issues in health care that currently seems unfathomable. Our praxiographic analysis of the discourse enabled us to understand the difficulties involved in translating renal health care networks across cultural contexts in Australia and to understand the dynamic and contested nature of these networks. The actor network approach has its limitations, however, particularly in the articulation of possible strategies to align two disparate systems in a way that would ensure better health care for Indigenous renal patients. In this paper we will discuss some of the problems we encountered in drawing on this methodology in our attempt to unearth practical solutions to the conundrums our data presented.

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ID Code: 64549
Item Type: Journal Article
Refereed: Yes
Keywords: praxiography, renal disease, Indigenous Australians, Indigenous patients, Australia, qualitative
ISSN: 1609-4069
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 18 Nov 2013 01:10
Last Modified: 20 Nov 2013 05:15

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