New York Center for Liver Transplantation, Inc., East Greenbush, NY, USA.
Liver Transpl. 2010 Jan;16(1):42-8. doi: 10.1002/lt.21937.
The number of liver donors has not measurably increased since 2004 and has begun to decrease. Although many waitlisted patients may be suitable candidates to receive a living donor graft, they are often reticent to discuss living donation with close friends and family, partly because of a lack of knowledge about donor health and quality of life outcomes after donation. The objective of this study was to test the effectiveness of an educational intervention that uses testimonials and self-report data from living donors in New York State. The study had an independent sample pretest (n = 437) and posttest (n = 338) design with posttest, between-subjects comparison for intervention exposure. All waitlisted patients at 5 liver transplant centers in New York were provided a peer-based educational brochure and DVD either by mail or at the clinic. The outcome measures were liver candidates' knowledge and self-efficacy to discuss living donation with family and friends. The number and proportion of individuals who presented to centers for living liver donation evaluation were also measured. Liver transplant candidates' self-efficacy to discuss living donation and their knowledge increased from the pretest period to the posttest period. Those exposed to the peer-based intervention reported significantly greater knowledge, a greater likelihood of discussing donation, and increased self-efficacy in comparison with those not exposed to the intervention. The results did not differ by age, length of time on the waiting list, education, or ethnicity. In comparison with the preintervention period, living donation increased 42%, and the number of individuals who presented for donation evaluation increased by 74%.
自 2004 年以来,肝供体数量并未显著增加,反而开始减少。尽管许多等待名单上的患者可能适合接受活体供体移植,但他们往往不愿与亲密的朋友和家人讨论活体捐赠,部分原因是对供体健康和捐赠后生活质量的结果缺乏了解。本研究的目的是检验一种教育干预措施的有效性,该措施使用了纽约州活体供体的见证和自我报告数据。该研究采用独立样本预测试(n = 437)和后测试(n = 338)设计,对干预暴露进行后测试、组间比较。纽约 5 家肝移植中心的所有等待名单上的患者都通过邮寄或在诊所收到了基于同伴的教育手册和 DVD。结果测量是肝候选者与家人和朋友讨论活体捐赠的知识和自我效能感。还测量了有多少人到中心接受活体肝捐赠评估。肝移植候选者讨论活体捐赠的自我效能感和知识从预测试期增加到后测试期。与未暴露于干预措施的人相比,接触基于同伴的干预措施的人报告了更高的知识、更有可能讨论捐赠以及增强的自我效能感。结果不因年龄、等待名单的时间长短、教育程度或种族而有所不同。与干预前相比,活体捐赠增加了 42%,有 74%的人前来进行捐赠评估。