Nonterah Camilla W, Utsey Shawn O, Gupta Gaurav, Wilkins Sawyer, Gardiner Heather M
Department of Psychology, University of Richmond, Richmond, VA, USA.
Department of Psychiatry, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA.
Prog Transplant. 2023 Jun;33(2):141-149. doi: 10.1177/15269248231164164. Epub 2023 Mar 20.
Completion of the renal transplant evaluation has been associated with several barriers for patients who identify as Black or African American. This study sought to prioritize barriers to and motivators of completing the renal transplant evaluation. Semi-structured interviews and focus groups with a nominal group technique were used to generate priority scores. Transplant professionals (N = 23) were recruited from 9 transplant centers in the Mid-Atlantic, Mid-Western, and Southeastern parts of the United States. Black or African American identifying renal patients (N = 30) diagnosed with end-stage kidney disease were recruited from 1 transplant center in the Mid-Atlantic region. Priority scores were created to assess the quantitative data of participant rankings of top barriers and motivators. The most significant barriers identified by both patients and transplant professionals comprised financial constraints, insurance issues, difficulty navigating the healthcare system, transportation difficulties, and multiple health problems. Facilitators consisted of family/social support, transplant education, patient navigators, comprehensive insurance, and physician repertoire and investment. A qualitative description of the ranked factors resulted in themes classified as intrapersonal, health, socioeconomic, transplant-specific healthcare, and general healthcare. These findings provided vital information to transplant centers nationwide about assessing the influences of renal transplant evaluation completion. Achieving equity in access to transplantation for Black or African American renal patients requires multilayered approaches.
对于那些认定自己为黑人或非裔美国人的患者而言，完成肾移植评估存在若干障碍。本研究旨在确定完成肾移植评估的障碍及推动因素的优先级。采用半结构化访谈和运用名义群体技术的焦点小组来生成优先级分数。移植专业人员（N = 23）来自美国中大西洋地区、中西部地区和东南部地区的9个移植中心。确诊为终末期肾病的认定自己为黑人或非裔美国人的肾移植患者（N = 30）来自中大西洋地区的1个移植中心。创建优先级分数以评估参与者对首要障碍和推动因素排名的定量数据。患者和移植专业人员共同确定的最重大障碍包括经济限制、保险问题、医疗系统就医困难、交通困难以及多种健康问题。推动因素包括家庭/社会支持、移植教育、患者导航员、综合保险以及医生的技能和投入。对排名因素的定性描述产生了归类为人际、健康、社会经济、移植特定医疗保健和一般医疗保健的主题。这些发现为全国的移植中心提供了关于评估完成肾移植评估影响的重要信息。实现黑人或非裔美国人肾移植患者移植机会的公平性需要采取多层次方法。
