학술논문

Recommendations for Systematizing Transplant Education Within a Care Delivery System for Patients With Chronic Kidney Disease Stages 3 to 5
Document Type
article
Source
Progress in Transplantation. 30(2)
Subject
Health Services and Systems
Health Sciences
Kidney Disease
Organ Transplantation
Transplantation
Clinical Research
Clinical Trials and Supportive Activities
7.1 Individual care needs
Management of diseases and conditions
Renal and urogenital
Quality Education
Culturally Competent Care
Decision Making
Female
Humans
Interviews as Topic
Kidney Transplantation
Male
Patient Education as Topic
Renal Insufficiency
Chronic
Severity of Illness Index
transplant donor
deceased < body regions
related < body regions
anonymous < body regions
kidney transplant recipient < body regions
education
health-care quality
access
and evaluation
Nursing
Surgery
Language
Abstract
ContextEarly tailored transplant education could help patients make informed transplant choices.ObjectiveWe interviewed 40 patients with chronic kidney disease (CKD) stages 3 to 5, 13 support persons, and 10 providers at Kaiser Permanente Southern California to understand: (1) barriers to transplant education and (2) transplant educational preferences and recommendations based on CKD stage and primary language spoken.DesignA grounded theory analysis identified central themes related to transplant education barriers, preferences, and recommendations.ResultsBarriers included confusion about diagnosis and when transplant may be necessary, concerns about transplant risks, families' lack of transplant knowledge, financial burdens, transportation and scheduling, and the emotional overload of chronic illness. Hispanic and Spanish-speaking participants reported difficulty in understanding transplant education and medical mistrust. Recommendations included providing general education, earlier introduction to transplant, wait-listing information, transplant education for support persons, living donation education for patients and potential donors, opportunities to meet living donors and kidney recipients, information on the benefits of transplant, recovery, and available financial resources, flexible class scheduling, online and print resources, and more provider follow-up. Spanish-speaking and Hispanic participants recommended using bilingual educators, print, video, and online resources in Spanish, and culturally responsive education. Patients with CKD stages 3 to 4 wanted information on slowing disease progression and avoiding transplant.ConclusionIncreasing access to culturally responsive transplant education in multiple languages, pairing appropriate content to the disease stage, and increasing system-wide follow-up as the disease progresses might help patients make more informed choices about transplant.