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卢旺达费萨尔国王医院医疗服务提供者对肾脏移植项目的看法:为期一年的评估。

Healthcare providers' perceptions of the kidney transplant program at King Faisal Hospital Rwanda: A one-year evaluation.

作者信息

Martinelli Marissa, Twagirumukiza Emile, Elbasha Ahmed M, Sendegeya Augustin, Uwurukundo Belise S, Karangwa Jules, Neil Kara L, Nshimiyimana Laetitia, Punch Jeffrey

机构信息

University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, United States of America.

King Faisal Hospital Rwanda, Kigali, Rwanda.

出版信息

PLOS Glob Public Health. 2025 Jul 28;5(7):e0004905. doi: 10.1371/journal.pgph.0004905. eCollection 2025.

Abstract

The living donor kidney transplant program was established at King Faisal Hospital Rwanda (KFH) in 2023, to reduce medical abroad referrals and strengthen the health care delivery system. The study aimed to explore healthcare provider perspectives, their needs for further developing the kidney transplant program at KFH and provide recommendations to fill these gaps. This study employed a sequential explanatory mixed methods approach embedded within an overarching exploratory research design, collecting data from healthcare workers who participated in at least one kidney transplant mission at KFH since 2023. Participants represented the dialysis, outpatient renal clinics, operating theatres, and postoperative kidney transplant units. Data were collected through initial surveys, which informed the semi-structured interviews. Descriptive and thematic analyses of the results were performed. The study included 50 respondents. 32% of respondents were extremely satisfied with the devices, infrastructure, and technology used in kidney transplantation at KFH, while also positing that missing or non-functional devices limit their ability to care for kidney transplant patients. 11 healthcare providers were interviewed. The most reported strength of the program was effective governance and management systems, while the areas needing improvement were education and training, patient care coordination, infrastructure, instruments, and devices. The findings of this study underscore the importance of strong political and institutional will, hospital organization, and multidisciplinary team collaboration in sustaining renal transplantation programs. Participants recommended practical-based training, rotations into high-volume facilities, and regular refresher training. Early renal disease diagnosis and ensuring treatment affordability were also recommended.

摘要

2023年,卢旺达费萨尔国王医院(KFH)设立了活体供肾移植项目,以减少国外就医转诊并加强医疗服务提供系统。该研究旨在探讨医疗服务提供者的观点、他们对进一步发展KFH肾移植项目的需求,并提出填补这些差距的建议。本研究采用了一种序列解释性混合方法,嵌入在一个总体探索性研究设计中,从自2023年以来在KFH参与至少一次肾移植任务的医护人员中收集数据。参与者来自透析、门诊肾脏诊所、手术室和肾移植术后病房。通过初步调查收集数据,这些调查为半结构化访谈提供了信息。对结果进行了描述性和主题性分析。该研究包括50名受访者。32%的受访者对KFH肾移植中使用的设备、基础设施和技术非常满意,同时也指出缺少或无法正常使用的设备限制了他们照顾肾移植患者的能力。对11名医疗服务提供者进行了访谈。该项目最常被提及的优势是有效的治理和管理系统,而需要改进的领域是教育和培训、患者护理协调、基础设施、仪器和设备。本研究的结果强调了强有力的政治和机构意愿、医院组织以及多学科团队合作在维持肾移植项目中的重要性。参与者建议进行基于实践的培训、到高容量设施轮岗以及定期进修培训。还建议早期诊断肾脏疾病并确保治疗的可负担性。

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