Sullivan C, Dolata J, Barnswell K V, Greenway K, Kamps C M, Marbury Q, Pencak J A, Wilson D, Perzynski A T, Sehgal A R, Huml A M
Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH.
Division of Transplantation, Department of Surgery, University of Louisville, Louisville, KY.
Transplant Proc. 2018 Dec;50(10):3346-3350. doi: 10.1016/j.transproceed.2018.02.090.
The use of trained kidney transplant recipients as patient navigators resulted in increased completion of the steps in the transplant process by dialysis patients. We sought to understand the experiences of these patient navigators.
Six kidney transplant recipients were hired and employed by transplant centers in Ohio, Kentucky, and Indiana. The transplant navigators received formal training as peer educators, met with dialysis patients on a regular basis, and provided tailored education and assistance about transplantation to each patient. They worked closely with the pretransplant coordinators and social workers to learn the details of each patient's transplant work-up.
We queried navigators using open-ended questions to learn about their experiences. Navigator responses were coded and common themes identified. A thematic auditor reviewed and refined the coding.
Two primary categories of themes emerged about the navigator experience: 1. practical comments that supported programmatic or implementation observations of the navigators, and 2. affective comments that reflected a shared experience among the navigators and patients. The navigators were able to fill voids in the transplant process that were not fulfilled by other caregivers. This was accomplished by a natural bond based upon a shared experience (of dialysis and kidney failure) between the navigator and the patient. The patient and navigator became experiential partners.
Kidney transplant recipients trained as patient navigators fill the role of a nontraditional medical provider, offer support during the transplant process, and provide an added benefit to complement routine dialysis and nephrology care.
使用经过培训的肾移植受者作为患者导航员，可提高透析患者在移植过程中各步骤的完成率。我们试图了解这些患者导航员的经历。
六名肾移植受者受雇于俄亥俄州、肯塔基州和印第安纳州的移植中心。移植导航员接受了作为同伴教育者的正规培训，定期与透析患者会面，并为每位患者提供有关移植的定制教育和帮助。他们与移植前协调员和社会工作者密切合作，了解每位患者移植检查的详细情况。
我们使用开放式问题询问导航员以了解他们的经历。对导航员的回答进行编码并确定共同主题。一名主题审核员对编码进行了审核和完善。
关于导航员经历出现了两大类主题：1. 支持对导航员进行项目或实施观察的实际意见，以及2. 反映导航员和患者之间共同经历的情感意见。导航员能够填补移植过程中其他护理人员未满足的空白。这是通过基于导航员与患者之间（透析和肾衰竭的）共同经历而形成的自然纽带实现的。患者和导航员成为了经验上的伙伴。
接受培训成为患者导航员的肾移植受者充当了非传统医疗提供者的角色，在移植过程中提供支持，并为常规透析和肾病护理提供补充的额外益处。
