Seattle Children's Hospital, Seattle, WA, USA.
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
Pediatr Transplant. 2021 May;25(3):e13896. doi: 10.1111/petr.13896. Epub 2020 Oct 28.
Poor self-management contributes to reduced renal allograft survival during adolescence and young adulthood. Providing patients with self-reflection tools to help explore the question "Is my experience normal?" may help mitigate these challenges. We explore Photograph-elicitation, a qualitative method where images are used to prompt individuals to talk about their personal experiences and values, engages pediatric transplant recipients and their families to generate insight into their experiences and the challenges they face after transplant.
DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Pediatric renal transplant recipients and one family member from Seattle Children's Hospital submitted 5 photographs showcasing their transplant story, which were used as prompts during semi-structured interviews. Interviews were recorded, transcribed, and analyzed using thematic analysis.
Twenty-four individuals (13 patients: ages 7-21, and 11 parents) completed the study. Conversations generated by the photographs covered topics in more depth than a routine clinical encounter leading to more opportunities for reflection by patients and their family. The photographs generated conversations on four emergent themes: (a) sensemaking; (b) transitions and agency; (c) social interactions and community engagement; and (d) barriers and obstacles.
Photograph elicitation generated a rich dataset describing a range of pediatric renal transplant experiences helping physicians gain a rich and nuanced understanding of the daily lives and experiences of their patients outside the clinical setting. Photograph elicitation, as a clinical intervention, may provide new opportunities to address previously unrecognized modifiable risk factors, improving graft survival and health-related quality of life.
在青少年和青年时期，自我管理不善会导致肾移植存活率降低。为患者提供自我反思工具，以帮助他们探索“我的经历正常吗？”这个问题，可能有助于缓解这些挑战。我们探索了照片启发法，这是一种通过图像来引导个体谈论自己的个人经历和价值观的定性方法，它可以让儿科肾移植受者及其家人深入了解他们在移植后的经历和面临的挑战。
设计、地点、参与者和测量：西雅图儿童医院的 24 名儿科肾移植受者及其 1 名家庭成员提交了 5 张展示他们移植故事的照片，这些照片在半结构化访谈中用作提示。访谈进行了录音、转录，并使用主题分析进行了分析。
24 人（13 名患者：年龄 7-21 岁，11 名父母）完成了这项研究。照片引发的对话比常规临床就诊更深入地涵盖了主题，为患者及其家人提供了更多反思的机会。照片生成了四个主题的对话：（a）理解；（b）过渡和代理；（c）社会互动和社区参与；以及（d）障碍和困难。
照片启发法生成了一个丰富的数据集，描述了一系列儿科肾移植经历，帮助医生在临床环境之外更深入地了解患者的日常生活和经历。作为一种临床干预，照片启发法可能为解决以前未被认识到的可改变的风险因素提供新的机会，从而提高移植物存活率和健康相关生活质量。
