Malik Muhammad Shahzar, Abideen Zain-Ul, Akoh Jacob A, Houlberg Kris
From the Southwest Transplant Centre, University Hospitals Plymouth National Health Service Trust, United Kingdom.
Exp Clin Transplant. 2023 Apr;21(4):307-316. doi: 10.6002/ect.2023.0025.
The shortage of donor organs is the most limiting factor in kidney transplant practice today. New monitoring technologies are being investigated to reduce graft loss due to vascular complications. We assessed the feasibility of a novel blood flow monitoring device, the implantable Doppler probe, in kidney transplant surgery. This patient-public involvement consultation explored the views and expectations of the stakeholders (kidney transplant recipients, surgeons, clinicians, and nurses with direct experience of the implantable Doppler probe) on the protocol development of our feasibility study. Our objective was to improve the protocol, understand stakeholder perceptions regarding research in postoperative graft surveillance, and identify potential confounding factors to the research and challenges to implementation of implantable Doppler probe in clinical practice.
We conducted semi-structured interviews containing open-ended questions with 12 stakeholders. We performed thematic analysis of the data at the latent level by an inductive approach according to a 6-phase guide by Braun and Clarke using NVivo 12 software.
Three key themes emerged. (1) Experiences with the implantable Doppler probe as a monitoring device showed that it was well received by the patients; however, there was a clinical equipoise among the health care professionals. (2) Recognition of the need for research in the early postoperative graft monitoring displayed stakeholder understanding regarding the role of a blood flow monitoring device to improve surgical outcomes. (3) Recommendations for smooth conduct of the proposed study include suggestions for improvement of the study protocol, informative sessions for the patients and nurses, and innovative ideas to improve the monitoring device.
Patient-public involvement consultation was crucial for the research design of our proposed feasibility study. Useful strategies and a patient- centered approach were incorporated to mitigate the potential challenges to the conduct of the research.
供体器官短缺是当今肾移植实践中最具限制的因素。正在研究新的监测技术,以减少因血管并发症导致的移植物丢失。我们评估了一种新型血流监测设备——植入式多普勒探头在肾移植手术中的可行性。本次患者-公众参与咨询探讨了利益相关者(肾移植受者、外科医生、临床医生以及有植入式多普勒探头直接经验的护士)对我们可行性研究方案制定的看法和期望。我们的目标是改进方案,了解利益相关者对术后移植物监测研究的看法,并识别该研究的潜在混杂因素以及在临床实践中实施植入式多普勒探头的挑战。
我们对12名利益相关者进行了包含开放式问题的半结构化访谈。我们根据布劳恩和克拉克的六阶段指南,采用归纳法,使用NVivo 12软件对潜在层面的数据进行了主题分析。
出现了三个关键主题。(1)作为监测设备的植入式多普勒探头的使用经验表明,患者对其接受度良好;然而,医护人员之间存在临床平衡。(2)认识到术后早期移植物监测研究的必要性,表明利益相关者理解血流监测设备对改善手术结果的作用。(3)关于顺利开展拟议研究的建议包括改进研究方案、为患者和护士举办信息交流会以及改进监测设备的创新想法。
患者-公众参与咨询对于我们拟议的可行性研究的研究设计至关重要。纳入了有用的策略和以患者为中心的方法,以减轻研究开展的潜在挑战。