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一个提高对活体肾移植认识的数字图书馆:形成性研究。

A Digital Library for Increasing Awareness About Living Donor Kidney Transplants: Formative Study.

作者信息

Waterman Amy D, Wood Emily H, Ranasinghe Omesh N, Faye Lipsey Amanda, Anderson Crystal, Balliet Wendy, Holland-Carter Lauren, Maurer Stacey, Aurora Posadas Salas Maria

机构信息

Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.

Terasaki Research Institute, Los Angeles, CA, United States.

出版信息

JMIR Form Res. 2020 Jul 21;4(7):e17441. doi: 10.2196/17441.

Abstract

BACKGROUND

It is not common for people to come across a living kidney donor, let alone consider whether they would ever donate a kidney themselves while they are alive. Narrative storytelling, the sharing of first-person narratives based on lived experience, may be an important way to improve education about living donor kidney transplants (LDKTs). Developing ways to easily standardize and disseminate diverse living donor stories using digital technology could inspire more people to consider becoming living donors and reduce the kidney shortage nationally.

OBJECTIVE

This paper aimed to describe the development of the Living Donation Storytelling Project, a web-based digital library of living donation narratives from multiple audiences using video capture technology. Specifically, we aimed to describe the theoretical foundation and development of the library, a protocol to capture diverse storytellers, the characteristics and experiences of participating storytellers, and the frequency with which any ethical concerns about the content being shared emerged.

METHODS

This study invited kidney transplant recipients who had received LDKTs, living donors, family members, and patients seeking LDKTs to record personal stories using video capture technology by answering a series of guided prompts on their computer or smartphone and answering questions about their filming experience. The digital software automatically spliced responses to open-ended prompts, creating a seamless story available for uploading to a web-based library and posting to social media. Each story was reviewed by a transplant professional for the disclosure of protected health information (PHI), pressuring others to donate, and medical inaccuracies. Disclosures were edited.

RESULTS

This study recruited diverse storytellers through social media, support groups, churches, and transplant programs. Of the 137 storytellers who completed the postsurvey, 105/137 (76.6%) were white and 99/137 (72.2%) were female. They spent 62.5 min, on average, recording their story, with a final median story length of 10 min (00:46 seconds to 32:16 min). A total of 94.8% (130/137) of storytellers were motivated by a desire to educate the public; 78.1% (107/137) were motivated to help more people become living donors; and 75.9% (104/137) were motivated to dispel myths. The ease of using the technology and telling their story varied, with the fear of being on film, emotional difficulty talking about their experiences, and some technological barriers being reported. PHI, most commonly surnames and transplant center names, was present in 62.9% (85/135) of stories and was edited out.

CONCLUSIONS

With appropriate sensitivity to ensure diverse recruitment, ethical review of content, and support for storytellers, web-based storytelling platforms may be a cost-effective and convenient way to further engage patients and increase the curiosity of the public in learning more about the possibility of becoming living donors.

摘要

背景

人们遇到活体肾捐赠者的情况并不常见,更不用说考虑自己是否会在生前捐赠肾脏了。叙事性故事讲述,即基于生活经历分享第一人称叙述,可能是改善活体肾移植(LDKT)教育的重要方式。开发利用数字技术轻松规范和传播多样化活体捐赠者故事的方法,可能会激励更多人考虑成为活体捐赠者,并减少全国范围内的肾脏短缺。

目的

本文旨在描述活体捐赠故事讲述项目的发展情况,这是一个基于网络的数字图书馆,使用视频捕捉技术收录了来自多个群体的活体捐赠叙述。具体而言,我们旨在描述该图书馆的理论基础和发展情况、捕捉不同讲述者的方案、参与讲述者的特征和经历,以及出现的对所分享内容的任何伦理问题的频率。

方法

本研究邀请接受过LDKT的肾移植受者、活体捐赠者、家庭成员以及寻求LDKT的患者,通过在电脑或智能手机上回答一系列引导性提示问题并回答有关拍摄经历的问题,使用视频捕捉技术记录个人故事。数字软件会自动拼接对开放式提示的回答,生成一个无缝故事,可供上传到基于网络的图书馆并发布到社交媒体上。每个故事都由移植专业人员审查,以检查是否披露了受保护的健康信息(PHI)、是否向他人施压进行捐赠以及是否存在医学错误信息。对披露内容进行了编辑。

结果

本研究通过社交媒体、支持小组、教会和移植项目招募了不同的讲述者。在137名完成调查后问卷的讲述者中,105/137(76.6%)为白人,99/137(72.2%)为女性。他们平均花费62.5分钟录制故事,最终故事中位数长度为10分钟(00:46秒至32:16分钟)。共有94.8%(130/137)的讲述者受教育公众的愿望驱使;78.1%(107/137)受帮助更多人成为活体捐赠者的愿望驱使;75.9%(104/137)受消除误解的愿望驱使。使用该技术和讲述故事的难易程度各不相同,有人报告存在害怕上镜、谈论经历时情绪困难以及一些技术障碍。PHI最常见的是姓氏和移植中心名称,出现在62.9%(85/135)的故事中,并被编辑掉了。

结论

在确保多样化招募、对内容进行伦理审查以及为讲述者提供支持方面保持适当的敏感性,基于网络的故事讲述平台可能是一种经济高效且便捷的方式,可进一步吸引患者并增加公众对了解更多成为活体捐赠者可能性的好奇心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abf/7404010/871cc75f1f82/formative_v4i7e17441_fig1.jpg

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