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接受腹膜透析患者拒绝肾移植的原因:一项定性研究。

Reasons for kidney transplant refusal among patients receiving peritoneal dialysis: A qualitative study.

机构信息

Nursing and Midwifery Faculty, Birjand University of Medical Sciences, Iran.

Medical-Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Iran.

出版信息

Perit Dial Int. 2023 Sep;43(5):395-401. doi: 10.1177/08968608221146865. Epub 2023 Jan 4.

DOI:10.1177/08968608221146865
PMID:36601692
Abstract

BACKGROUND

Even though kidney transplantation has better outcomes compared to dialysis therapies, some patients undergoing peritoneal dialysis (PD) refuse to consider kidney transplantation. Identification of the underlying reason for patient refusal may improve patients' acceptance of kidney transplantation.

AIM

The aim of this study was to describe the reasons given by Iranian PD patients for refusing kidney transplantation.

METHOD

Eighteen patients undergoing PD participated. Data were collected using semi-structured interviews and were analysed using conventional qualitative content analysis.

RESULTS

The analysis leads to the emergence of two categories and six subcategories: negative outcomes of kidney transplantation (financial burden, psychosocial problems and physical complications) and doubtful factors for kidney transplantation (negative attitudes towards kidney transplantation, long waiting time for kidney transplantation and compatibility of PD with daily life). The financial burden and long waiting time for kidney transplantation were the most important factors in the reluctance of kidney transplantation by PD patients.

IMPLICATION FOR PRACTICE

Patients undergoing PD declined kidney transplantation for several reasons, such as financial burden, fear of post-transplantation side effects, long waiting time for kidney transplantation. Reducing the time of kidney transplantation and insurance coverage of transplant costs can change the attitude of PD patients towards transplant.

摘要

背景

尽管与透析疗法相比,肾移植有更好的结果,但仍有一些接受腹膜透析(PD)的患者拒绝考虑肾移植。确定患者拒绝的根本原因可能会提高患者对肾移植的接受度。

目的

本研究旨在描述伊朗 PD 患者拒绝肾移植的原因。

方法

18 名接受 PD 的患者参与了研究。数据收集采用半结构式访谈,采用常规定性内容分析进行分析。

结果

分析产生了两个类别和六个亚类别:肾移植的负面后果(经济负担、心理社会问题和身体并发症)和肾移植的可疑因素(对肾移植的负面态度、肾移植的等待时间长和 PD 与日常生活的兼容性)。肾移植的经济负担和等待时间长是 PD 患者不愿意进行肾移植的最重要因素。

对实践的影响

接受 PD 的患者拒绝肾移植的原因有很多,例如经济负担、对移植后副作用的恐惧、肾移植等待时间长。减少肾移植的时间和移植费用的保险覆盖范围可以改变 PD 患者对移植的态度。

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