Graduation Year


Document Type

Senior Thesis


Bachelor of Science in Nursing

Primary Major


Thesis Advisor

Patricia Harris PhD, RN, CNS


From a Public Health Nursing (PHN) perspective, populations who are diagnosed with chronic disease or illness are the most vulnerable to end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). The International Society of Nephrology (ISN) states that the mortality rate for ESKD amounts to roughly 7 million individuals worldwide. In examining causes of ESKD throughout both history and the lifespan, high mortality rates are attributed to the lack of access to life-sustaining therapies such as dialysis or transplantation. The lack of access to therapy or healthcare services has been an immense Public Health crisis in the last few decades. Accessibility to various resources such as healthcare, transportation, food, and other basic needs, are defined as social determinants. Typically, a lack of accessibility equates to poor health, and an abundance of accessibility equates to optimal health. In rural countries such as the Philippines, accessibility is questionable, and populations suffer from a lack of research addressing the relationship between social determinants and quality of health.

A comprehensive literature review was performed, and a gap was observed in the current research literature that focuses on Philippine populations and renal therapies. Dialysis or other life-sustaining treatments are less available for individuals in low-research settings. The root of the issue is systemic, indicating that intervention must be done at the governmental or authoritative forefront. A research study is proposed to address this gap.