Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY; Recanati-Miller Transplantation Institute at Mount Sinai, The Zweig Family Center for Living Donation, New York, NY.
Psychosomatics. 2017 Sep-Oct;58(5):519-526. doi: 10.1016/j.psym.2017.03.012. Epub 2017 Mar 16.
The psychosocial evaluation is an important part of the live organ donor evaluation process, yet this is not standardized across institutions.
This study was designed to prospectively test the reliability and validity of a semistructured psychosocial evaluation tool that was recently developed and reported in the literature (the Live Donor Assessment Tool [LDAT]).
A total of 248 live donor candidates who presented for evaluation were invited to participate in a study that involved the LDAT being scored as part of the standard psychosocial evaluation process; 222 provided informed consent. Evaluations were conducted by staff experienced with psychosocial evaluation of living donors and trained in the use of the LDAT. Furthermore, 123 donor candidates were evaluated twice, as per routine standard of care, and had 2 LDATs administered. Reliability of the LDAT was assessed by calculating the internal consistency of the LDAT items and inter-rater reliability. Validity was assessed by comparing LDAT scores across the risk-group categories (the traditional outcome designation of the psychosocial evaluation) and in 86 eventual donors, associations between LDAT scores, and indicators of psychosocial outcomes post-donation.
The LDAT was found to have good internal consistency, strong inter-rater reliability, and showed signs of validity: LDAT scores differentiated the traditional risk-group categories, and a significant association between LDAT score and treatment adherence post-donation was revealed.
The LDAT demonstrated good reliability and validity, but future research on the LDAT and the ability to implement the LDAT across institutions is warranted.
心理社会评估是活体器官捐献者评估过程中的一个重要组成部分,但各机构对此并未进行标准化。
本研究旨在前瞻性检验一种最近开发并在文献中报道的半结构式心理社会评估工具(活体供者评估工具 [LDAT])的可靠性和有效性。
共有 248 名活体捐献者候选人受邀参加一项研究,该研究将 LDAT 评分作为标准心理社会评估过程的一部分;222 人提供了知情同意。评估由具有活体供者心理社会评估经验并接受过 LDAT 使用培训的工作人员进行。此外,按照常规标准护理,对 123 名捐献者候选人进行了两次评估,并进行了 2 次 LDAT 评估。LDAT 的可靠性通过计算 LDAT 项目的内部一致性和评分者间可靠性来评估。通过比较 LDAT 评分在风险组类别(心理社会评估的传统结果指定)之间以及在 86 名最终捐献者中的表现,评估 LDAT 评分与捐赠后心理社会结果指标之间的关系来评估有效性。
LDAT 具有良好的内部一致性、较强的评分者间可靠性,并且具有有效性的迹象:LDAT 评分可区分传统的风险组类别,并且 LDAT 评分与捐赠后治疗依从性之间存在显著关联。
LDAT 具有良好的可靠性和有效性,但需要进一步研究 LDAT 及其在各机构之间实施的能力。