Faculty of Nursing, 3158University of Alberta Edmonton, Alberta, Canada.
5229University of Wisconsin Hospital and Clinics, Madison, WI, USA.
Prog Transplant. 2021 Mar;31(1):32-39. doi: 10.1177/1526924820978599. Epub 2020 Dec 10.
Although informed consent content elements are prescribed in detailed regulatory guidance, many live kidney donors describe feeling underprepared and under informed. The goal of this pilot study was to explore the educational components needed to support an informed decision-making process for living kidney donors.
METHODS/APPROACH: A qualitative description design was conducted with thematic analysis of 5 focus groups with 2 cohorts: living kidney donor candidates (n = 11) and living kidney donors (n = 8).
The educational components needed to engage in an informed decision-making process were: 1) contingent upon, and motivated by, personal circumstances; 2) supported through explanation of risks and benefits; 3) enhanced by understanding the overall donation experience; and 4) personalized by talking to another donor.
Tailoring education to meet the needs for fully informed decision-making is essential. Current education requirements, as defined by regulatory bodies, remain challenging to transplant teams attempting to ensure fully informed consent of living kidney donor candidates. Information on the emotional, financial, and overall life impact is needed, along with acknowledgement of relational ties driving donor motivations and the hoped-for recipient outcomes. Discussion of care practices, and access to peer mentoring may further strengthen the informed decision-making process.
尽管详细的监管指南规定了知情同意书的内容要素,但许多活体肾脏捐献者表示感到准备不足和信息不足。本试点研究的目的是探讨支持活体肾脏捐献者做出知情决策过程所需的教育内容。
方法/方法:采用定性描述设计,对 2 个队列的 5 个焦点小组进行主题分析:活体肾脏捐献者候选人(n=11)和活体肾脏捐献者(n=8)。
参与知情决策过程所需的教育内容包括:1)取决于个人情况,并受其激励;2)通过解释风险和收益来支持;3)通过了解整个捐赠过程来增强;4)通过与另一位捐赠者交谈来个性化。
根据需要量身定制教育以实现充分知情决策至关重要。监管机构定义的当前教育要求对于试图确保活体肾脏捐献者候选人完全知情同意的移植团队仍然具有挑战性。需要提供有关情感、财务和整体生活影响的信息,同时承认推动捐赠者动机的关系纽带以及预期的受赠者结果。讨论护理实践并提供同行指导可能会进一步加强知情决策过程。