Erasmus MC, Department of Medical Psychology, Rotterdam, The Netherlands.
Patient Educ Couns. 2013 Jan;90(1):118-24. doi: 10.1016/j.pec.2012.08.004. Epub 2012 Aug 30.
Despite living donor kidney transplantation (LDKT) being the optimal treatment option for patients with end-stage renal disease, we observed a significant inequality in the number of LDKT performed between patients of Dutch versus non-Dutch descent. We conducted a focus group study to explore modifiable hurdles to LDKT.
Focus group discussions and in-depth interviews were conducted among 50 end-stage renal patients. Analyses were conducted according to 'grounded theory' using Atlas.ti.
We found nearly all patients to be in favor of LDKT (96%). However, multiple factors played a role in considering LDKT. Four potentially modifiable hurdles were derived: (1) inadequate patient education, (2) impeding cognitions and emotions, (3) restrictive social influences, and (4) suboptimal communication. With regard to solutions, we found that our patients were open to home-based group education on renal replacement therapy options (88% in favor).
The study highlights the need for sensitivity and awareness of the influence of cultural factors on decision-making when discussing living donation with culturally diverse populations.
Since the majority of our patients were open to a tailored group education in their own homes, we see this as an opportunity to address factors that influence equality in access to LDKT.
尽管活体供肾移植（LDKT）是终末期肾病患者的最佳治疗选择，但我们观察到荷兰裔和非荷兰裔患者之间接受 LDKT 的数量存在显著不平等。我们进行了一项焦点小组研究，以探讨可改变的 LDKT 障碍。
对 50 名终末期肾病患者进行了焦点小组讨论和深入访谈。使用 Atlas.ti 根据“扎根理论”进行分析。
我们发现几乎所有患者都赞成 LDKT（96%）。然而，多种因素影响了他们对 LDKT 的考虑。得出了四个潜在的可改变的障碍：（1）患者教育不足，（2）认知和情绪障碍，（3）限制社会影响，以及（4）沟通不畅。关于解决方案，我们发现我们的患者对基于家庭的肾脏替代治疗选择的小组教育持开放态度（88%的人赞成）。
该研究强调了在与不同文化背景的人群讨论活体捐赠时，需要对文化因素对决策的影响保持敏感和认识。
由于我们的大多数患者都愿意在自己家中接受定制的小组教育，我们认为这是一个解决影响 LDKT 平等获得的因素的机会。
