1 Psychiatry-Medical Psychology and Psychotherapy, Erasmus MC, CA Rotterdam, The Netherlands. 2 Internal Medicine-Nephrology & Transplantation, Erasmus MC, CA Rotterdam, The Netherlands. 3 Address correspondence to: Sohal Y. Ismail, M.Sc., Psychiatry-Medical Psychology and Psychotherapy, Erasmus MC, Postbox 2040, Room GK-1252, 3000 CA Rotterdam, The Netherlands.
Transplantation. 2013 Sep;96(6):586-90. doi: 10.1097/TP.0b013e31829b754c.
We have observed a significant inequality in the number of living-donor kidney transplants (LDKT) performed between patients of non-Western European origin and those of Western European origin. The aim of this study was to investigate modifiable factors that could be used as potential targets for an intervention in an attempt to reduce this inequality.
A questionnaire on knowledge, risk perception, communication, subjective norm, and willingness to accept LDKT was completed by 160 end-stage renal patients who were referred to the pretransplantation outpatient clinic (participation rate of 92%). The questionnaire was available in nine languages. Multivariate analyses of variance were conducted to explore differences between patients with and without a living donor.
There were significantly fewer patients of non-Western descent (11 of 82) that brought a living donor to the outpatient clinic than patients of Western descent (38 of 78). After correcting for the unmodifiable sociodemographic factors non-Western descent, low knowledge, little communication about their kidney disease, and low willingness to communicate with individuals from the social network about LDKT were significantly associated with the absence of a living donor.
Knowledge and communication are identified as modifiable factors that are associated with the likelihood of identifying a potential living donor for LDKT. This observation makes knowledge and communication targets for interventions to reduce inequality in access to LDKT.
我们观察到，非西欧裔和西欧裔的活体供肾移植（LDKT）数量存在显著差异。本研究旨在探讨可改变的因素，这些因素可能成为干预的潜在目标，以试图减少这种不平等。
160 名终末期肾病患者接受了关于知识、风险感知、沟通、主观规范和接受 LDKT 意愿的问卷调查，这些患者被转介到移植前门诊（参与率为 92%）。问卷有九种语言版本。采用多元方差分析来探讨有和没有活体供者的患者之间的差异。
在来门诊的患者中，非西欧裔（11 名/82 名）的活体供者明显少于西欧裔（38 名/78 名）。在调整了不可改变的社会人口因素（非西欧裔、低知识、对肾脏疾病的沟通较少、以及对与社交网络中的人沟通 LDKT 的意愿较低）后，没有活体供者与低知识、沟通少和低沟通意愿显著相关。
知识和沟通被确定为与识别 LDKT 潜在活体供者的可能性相关的可改变因素。这一观察结果使知识和沟通成为减少 LDKT 机会不平等的干预目标。
