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开发一种远程医疗干预措施以改善活体供肾移植的可及性。

Development of a Telehealth Intervention to Improve Access to Live Donor Kidney Transplantation.

作者信息

Cabacungan A N, Diamantidis C J, St Clair Russell J, Strigo T S, Pounds I, Alkon A, Riley J A, Falkovic M, Pendergast J F, Davenport C A, Ellis M J, Sudan D L, Hill-Briggs F, Browne T, Ephraim P L, Boulware L E

机构信息

Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.

Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.

出版信息

Transplant Proc. 2019 Apr;51(3):665-675. doi: 10.1016/j.transproceed.2018.12.032. Epub 2019 Jan 9.

Abstract

BACKGROUND

Live donor kidney transplantation (LDKT) is underutilized by patients with end-stage kidney disease due to knowledge, communication, and logistical barriers.

MATERIAL AND METHODS

The Talking About Live Kidney Donation Social Worker Intervention (TALK-SWI) is a previously validated intervention demonstrated to improve patients' access to and pursuit of LDKT through in-person delivery of education and social support. To help overcome logistical barriers to LDKT, we adapted TALK-SWI into a telehealth intervention employing digital (ie, tablet, smartphone) and telephone technologies. We studied the usability and acceptability of both the mobile device and telephone counseling portions of the intervention among people with kidney disease. For the digital portion, we assessed critical (ie, inability to complete a task) and non-critical (ie, ability to complete a task utilizing an alternative method) errors participants encountered when using the program and their preferences regarding digital materials. Simultaneously, we assessed participants' satisfaction with telephone-adapted counseling compared to the original, in-person counseling.

RESULTS

The 15 participants testing the digital technology made 25 critical errors and 29 non-critical errors, while they easily completed 156 tasks (out of 210). A majority of participants (73%) preferred the tablet/smart phone education application over traditional materials, and most (80%) indicated they would be more likely to utilize the mobile platform over traditional materials. Participants testing the telephone-adapted (n = 45) and in-person (n = 125) social worker counseling all reported high satisfaction with the intervention.

CONCLUSION

We successfully adapted a validated educational and behavioral intervention to improve access to LDKT into a usable and acceptable telehealth intervention.

摘要

背景

由于知识、沟通和后勤方面的障碍,终末期肾病患者对活体供肾移植(LDKT)的利用率较低。

材料与方法

“谈论活体肾捐赠社会工作者干预措施(TALK-SWI)”是一项先前已得到验证的干预措施,通过面对面提供教育和社会支持,已证明该措施可改善患者获得和寻求LDKT的机会。为帮助克服LDKT的后勤障碍,我们将TALK-SWI改编为一种远程医疗干预措施,采用数字(即平板电脑、智能手机)和电话技术。我们研究了肾病患者对该干预措施中移动设备和电话咨询部分的可用性和可接受性。对于数字部分,我们评估了参与者在使用该程序时遇到的严重(即无法完成任务)和非严重(即能够使用替代方法完成任务)错误,以及他们对数字材料的偏好。同时,我们评估了参与者对电话适配咨询与原始面对面咨询相比的满意度。

结果

测试数字技术的15名参与者出现了25个严重错误和29个非严重错误,而他们轻松完成了210项任务中的156项。大多数参与者(73%)更喜欢平板电脑/智能手机教育应用程序而非传统材料,并且大多数(80%)表示他们更有可能使用移动平台而非传统材料。测试电话适配(n = 45)和面对面(n = 125)社会工作者咨询的参与者均报告对该干预措施高度满意。

结论

我们成功地将一项经过验证的教育和行为干预措施改编为一种可用且可接受的远程医疗干预措施,以改善获得LDKT的机会。

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