Wood Emily H, Waterman Amy D, Pines Rachyl
David Geffen School of Medicine, Los Angeles, California, USA.
David Geffen School of Medicine, Los Angeles, California, USA,
Blood Purif. 2021;50(4-5):655-661. doi: 10.1159/000512651. Epub 2021 Jan 13.
Policy changes including the Advancing American Kidney Health initiative and CMS's ESRD Quality Incentive Program recommend increasing educational initiatives within dialysis centers to increase living kidney donor transplant (LDKT) rates. LDKT education can be challenging in dialysis centers due to limited provider time to educate, patient fears or reluctance to learn about LDKT, and difficulty educating potential living donors. New educational innovations that increase dialysis patient curiosity about pursuing LDKT are needed.
Digital first-person storytelling, or the sharing of narratives by individuals in their own words, is a culturally competent, health literate, patient-driven approach to expanding patient understanding about LDKT that can supplement traditional educational strategies without additional burden for dialysis providers. The Living Donation Storytelling Project is an online digital library of over 150 video stories told by diverse kidney recipients, donors, those in search of a donor, and their family/friends. By honestly discussing how they overcame fears and challenges related to LDKT, these stories address sensitive topics that can be hard for providers to introduce by using easily accessible learning methodology that may better connect with racial/ethnic minorities, scared patients, and patients facing health literacy challenges. Key Messages: Supplementing traditional educational approaches with digital storytelling may help overcome time limitations in educating for busy providers, boost providers' own knowledge about LDKT, serve as a free supplemental resource for patients, reduce fears and increase self-efficacy about transplant, help more patients to share about transplant with their social networks, and ultimately increase LDKT rates.
政策变化,包括“推进美国肾脏健康”倡议和医疗保险与医疗补助服务中心的终末期肾病质量激励计划,建议在透析中心增加教育举措,以提高活体肾移植(LDKT)率。由于医护人员用于教育的时间有限、患者对了解LDKT存在恐惧或抵触情绪以及对潜在活体供体进行教育存在困难,在透析中心开展LDKT教育具有挑战性。因此,需要新的教育创新方法来提高透析患者对寻求LDKT的好奇心。
数字第一人称叙事,即个人用自己的语言分享故事,是一种具有文化适应性、具备健康素养且以患者为导向的方法,可用于加深患者对LDKT的理解,它能够补充传统教育策略,而不会给透析医护人员带来额外负担。“活体捐赠故事讲述项目”是一个在线数字图书馆,其中包含150多个由不同的肾脏接受者、捐赠者、寻找捐赠者的人以及他们的家人/朋友讲述的视频故事。通过诚实地讨论他们如何克服与LDKT相关的恐惧和挑战,这些故事探讨了一些敏感话题,而医护人员可能很难通过传统方式引入这些话题,该项目采用易于理解的学习方法,可能会更好地与少数族裔、心存恐惧的患者以及面临健康素养挑战的患者建立联系。关键信息:用数字叙事补充传统教育方法可能有助于克服忙碌医护人员在教育方面的时间限制,增加医护人员自身对LDKT的了解,为患者提供免费的补充资源,减少恐惧并增强对移植的自我效能感,帮助更多患者与社交网络分享移植相关信息,最终提高LDKT率。