Introduction This article focuses on the need to improve quality of life in African Americans with ESRD. Many patients who suffer from end-stage renal disease (ESRD), particularly those who do not access renal transplantation, have critical shorter life expectancy than others who have renal transplant. Prior to the introduction of dialysis, people who suffered renal conditions faced an inevitable death. However, improvements on treatment of renal conditions have improved in term of transplant and dialysis. As a result, lives of people with renal diseases have improved significantly. In fact, the US Renal Data System (USRDS) report of 2009 noted that ESRD is the “only disease-specific condition that is explicitly guaranteed Medicare coverage, with Medicare costs for the condition reaching $23.9 billion in 2007” (U.S. Renal Data System, 2009). It also noted that the rate of all-cause mortality for ESRD were about “six to eight times higher for dialysis patients than for the general population in the year 2007” (U.S. Renal Data System, 2009). During the year 2007, cases of ESRD decreased by 2.1 percent or 527,000 cases. This was the major decline rate since the year 2005. However, racial differences have persisted. For instance, in 2007 the African American had a high rate of 3.8 times compared to that of Native Americans, which was 1.8 times. Still, Hispanic populations had “1.5 times higher than that of other non-Hispanic population” (Vassalotti, Stevens and Levey, 2007). It is obvious that such improvements and prolonged lives have not reached all patients. There are several challenges, which patients with renal problems still face because of their conditions. Such challenges leave the patient with “feelings of depression and fatigue” (Ivey and Lane, 2011). Patients may experience changes in the body image due to “fistula or grafting for dialysis access” (Ivey and Lane, 2011). There are financial challenges because of weekly scheduled treatments and other emergency admission costs, which may result from renal complications. The condition also affects or threatens family relations and patient’s independence. Ivey and Lane noted that researchers have conducted several studies to identify factors, which may improve the quality of life of patients with ESRD. Discussion of the epistemological and ontological congruence between currently accepted scientific world views, the nursing paradigmatic world view, and your own perspective of nursing for your area of interest Stakeholders in ESRD management have carefully formulated the current methods or world views of managing and improving the quality of life among ESRD patients based on the recent knowledge in the field. However, according to the American Medical Association, these guidelines are “not standards of care, but are intended to assist practitioner and patient to make decisions about appropriate health care for specific clinical circumstances” (American Medical Association, 1996). These practices recognize that every clinical condition has unique attributes with several factors, which are more than what researchers have published from their studies. Some of these factors may include “patient characteristics, choice of physicians, cultural beliefs, personal values, and education” (Kliger and Haley, 1999). In addition, other fa