This paper describes Māori patients’ experiences and perspectives of chronic kidney disease (CKD). Thirteen Māori patients (aged 22–72 years) with CKD and who were either nearing the need for dialysis or had started dialysis within the previous 12 months participated in in-depth face-to-face semi-structured interviews at 3 dialysis centres in New Zealand, all of which offered all forms of dialysis modalities. The Māori concepts of whakamā (disempowerment and embarrassment) and whakamana (enhanced self-esteem and self-determination) provided an overarching framework for interpreting the themes identified: disempowered by delayed CKD diagnosis (resentment of late diagnosis; missed opportunities for preventive care; regret and selfblame); confronting the stigma of kidney disease (multigenerational trepidation; shame and embarrassment; fear and denial); developing and sustaining relationships to support treatment decision-making (importance of family/whānau; valuing peer support; building clinician-patient trust); and maintaining cultural identity (spiritual connection to land; and upholding inner strength/mana).
