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肾移植评估与登记:患者多媒体教育的开发与初步评估

Kidney Transplant Evaluation and Listing: Development and Preliminary Evaluation of Multimedia Education for Patients.

作者信息

Kayler Liise K, Dolph Beth, Ranahan Molly, Keller Maria, Cadzow Renee, Feeley Thomas H

机构信息

Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.

Transplant and Kidney Care Regional Center of Excellence, Erie County Medical Center, Buffalo, NY, USA.

出版信息

Ann Transplant. 2021 Mar 2;26:e929839. doi: 10.12659/AOT.929839.

Abstract

BACKGROUND Patient knowledge gaps about the evaluation and waitlisting process for kidney transplantation lead to delayed and incomplete testing, which compromise transplant access. We aimed to develop and evaluate a novel video education approach to empower patients to proceed with the transplant evaluation and listing process and to increase their knowledge and motivation. MATERIAL AND METHODS We developed 2 theory-informed educational animations about the kidney transplantation evaluation and listing process with input from experts in transplantation and communication, 20 candidates/recipients, 5 caregivers, 1 anthropologist, 3 community advocates, and 36 dialysis or transplant providers. We then conducted an online pre-post study with 28 kidney transplantation candidates to measure the acceptability and feasibility of the 2 videos to improve patients' evaluation and listing knowledge, understanding, and concerns. RESULTS Compared with before intervention, the mean knowledge score increased after intervention by 38% (5.7 to 7.9; P<0.001). Increases in knowledge effect size were large across age group, health literacy, education, technology access, and duration of pretransplant dialysis. The proportion of positive responses increased from before to after animation viewing for understanding the evaluation process (25% to 61%; P=0.002) and waitlist placement (32% to 86%; P<0.001). Concerns about list placement decreased (32% to 7%; P=0.039). After viewing the animations, >90% of responses indicated positive ratings on trusting the information, comfort level with learning, and engagement. CONCLUSIONS In partnership with stakeholders, we developed 2 educational animations about kidney transplant evaluation and listing that were positively received by patients and have the potential to improve patient knowledge and understanding and reduce patient concerns.

摘要

背景 患者在肾脏移植评估和等待名单流程方面存在知识缺口,导致检测延迟和不完整,这会影响移植机会。我们旨在开发并评估一种新颖的视频教育方法,以使患者能够推进移植评估和列入名单流程,并增加他们的知识和动力。

材料与方法 我们在移植和沟通领域的专家、20名候选者/受者、5名护理人员、1名人类学家、3名社区倡导者以及36名透析或移植提供者的参与下,制作了2部关于肾脏移植评估和列入名单流程的理论指导教育动画。然后,我们对28名肾脏移植候选者进行了一项在线前后对照研究,以衡量这2部视频在提高患者评估和列入名单的知识、理解以及担忧方面的可接受性和可行性。

结果 与干预前相比,干预后平均知识得分提高了38%(从5.7提高到7.9;P<0.001)。在年龄组、健康素养、教育程度、技术获取情况以及移植前透析时长等方面,知识效应大小的增加幅度都很大。对于理解评估流程(从25%增至61%;P=0.002)和等待名单安排(从32%增至86%;P<0.001),观看动画前后积极回应的比例有所增加。对名单安排的担忧减少了(从32%降至7%;P=0.039)。观看动画后,超过90%的反馈表明在信任信息、学习舒适度和参与度方面给予了积极评价。

结论 通过与利益相关者合作,我们制作了2部关于肾脏移植评估和列入名单的教育动画,患者对其评价良好,并且有潜力提高患者的知识和理解,减少患者的担忧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd7b/7936469/4c5c7bec0482/anntransplant-26-e929839-g001.jpg

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