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针对患有终末期肾病的非裔美国患者的活体供体移植教育。

Living donor transplant education for African American patients with end-stage renal disease.

作者信息

Arriola Kimberly R Jacob, Powell C Lamonte, Thompson Nancy J, Perryman Jennie P, Basu Mohua

机构信息

Emory University, Atlanta, Georgia.

Emory Transplant Center, Atlanta, Georgia.

出版信息

Prog Transplant. 2014 Dec;24(4):362-70. doi: 10.7182/pit2014830.

Abstract

CONTEXT

Despite numerous benefits of live donor kidney transplant (LDKT), patient-level barriers often prevent African Americans from considering LDKT. Educational interventions designed to address patient-level barriers may increase willingness among African American patients with end-stage renal disease to explore LDKT as a treatment option.

OBJECTIVE

To assess the effectiveness of a culturally sensitive educational intervention called Living ACTS (About Choices in Transplantation and Sharing) that was designed to address patient-level barriers to LDKT among African American patients with end-stage renal disease.

DESIGN/PARTICIPANTS: Patients were randomized to intervention (n = 136) or control (n = 132) groups. They completed baseline measures and then viewed either the Living ACTS or control video. Both groups then completed an immediate follow-up measure and a 6-month assessment administered via telephone.

MAIN OUTCOME MEASURES

Self-reported knowledge about LDKT, willingness to talk to the patient's family about LDKT, and perceived benefits of LDKT were measured at 3 time points.

RESULTS

At 6-month follow-up, intervention participants demonstrated a significantly greater increase in knowledge of LDKT than control participants (F2,229=3.08, P= .05). Intervention participants expressed greater willingness to talk to patients' families about LDKT than did control participants from baseline through 6-month follow-up (F1,230 = 7.11, P= .008). Finally, at immediate follow-up, intervention participants reported greater endorsement of the benefits of LDKT than did control participants (F2,223 = 14.27, P< .001); however, this effect had disappeared by the 6-month follow-up.

CONCLUSIONS

Living ACTS is effective at increasing and maintaining knowledge about LDKT among African American patients with end-stage renal disease who are considering transplant.

摘要

背景

尽管活体供肾移植(LDKT)有诸多益处,但患者层面的障碍常常使非裔美国人不愿考虑进行LDKT。旨在解决患者层面障碍的教育干预措施,可能会提高终末期肾病的非裔美国患者将LDKT作为一种治疗选择进行探索的意愿。

目的

评估一种名为“Living ACTS(关于移植和共享的选择)”的具有文化敏感性的教育干预措施的有效性,该措施旨在解决终末期肾病的非裔美国患者在接受LDKT时面临的患者层面障碍。

设计/参与者:患者被随机分为干预组(n = 136)或对照组(n = 132)。他们完成基线测量,然后观看Living ACTS视频或对照视频。两组随后都完成了即时随访测量以及通过电话进行的6个月评估。

主要结局指标

在3个时间点测量了关于LDKT的自我报告知识、与患者家属谈论LDKT的意愿以及对LDKT益处的认知。

结果

在6个月的随访中,干预组参与者在LDKT知识方面的增长显著高于对照组参与者(F2,229 = 3.08,P = .05)。从基线到6个月的随访期间,干预组参与者表示比对照组参与者更愿意与患者家属谈论LDKT(F1,230 = 7.11,P = .008)。最后,在即时随访时,干预组参与者报告对LDKT益处的认可程度高于对照组参与者(F2,223 = 14.2, P < .001);然而,到6个月随访时,这种效果已经消失。

结论

对于正在考虑移植的终末期肾病非裔美国患者,Living ACTS在增加和维持他们对LDKT的知识方面是有效的。

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