Candidate Comprehension of Key Concepts in Kidney Transplantation

Ahsanuddin, Sayeeda; Bento, Sandra; Swerdlow, Nicholas J.; Cervera, Ixel; Kayler, Liise K.

doi:10.12659/aot.892596

Cited by 15 publications

(14 citation statements)

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“…In the field of kidney transplantation, it is important to understand and be aware of the "seriousness" of the disease that caused the specific organ failure. However, it is necessary to realistically discuss what the transplantation means, to adequately inform the patient about transplant procedures and to support the willingness to face the surgery (10). Failure to adhere to immunosuppressive therapy may increase the risk of rejection of the transplanted organ and cause the loss of the latter.…”

Section: Discussionmentioning

confidence: 99%

“…Age, gender and hemoglobin level interfered with "general health" in all patients. 10 Most of the kidney recipients were compliant with the immunosuppressants. The women were less compliant than men with medications (P = .02), and poor compliance with medications was more frequent among those with living unrelated donors (P = .04).…”

Section: (Continued)mentioning

confidence: 99%

“…In transplantation, surgery allows rapid functioning from the anatomical and physiological point of view, but cognitive and emotional integration is also necessary ("psychological transplant") (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

“…Surgery such as transplantation is a time of great stress that threatens the sense of continuity and personal integrity, causing strong emotions and can alter one's personal identity, with the possible onset of psychopathology and psychosocial problems (10,(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

et al. 2020

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Kidney transplantation is a serious event that involves profound psychological, relational and social changes both for the patient and his family context. Assessment of personality profile, awareness of disease, family and social support of the patient candidate for kidney transplantation are necessary because factors not adequately considered, can influence the success of the transplant and alter the psychological stability of the patient. The present study aims to provide a systematic review of the literature of the last twelve years (2006-2018), focusing in particular on patient's readiness level and illness management and on possible psychopathology. Sixty-two studies were examined. Based on the Downs and Black checklist, most studies (n = 32) were of high quality; 15 of which related to lifestyle, health education, and therapeutic adherence in post-renal transplantation, 17 studies concerned the possible existence of psychopathology and cognitive impairment of renal deceased transplanted subjects. The literature used has shown that the population of kidney transplant patients is exposed to a high risk of psychiatric disorders with repercussions on the quality of life and the risk of rejection. Therefore, an adequate pre-transplant psychosocial assessment is necessary, which allows a more indepth knowledge of the candidate to plan coping strategies and possible posttransplant psychotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: (Continued)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

et al. 2020

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“…Available studies suggest longer duration of kidney disease is significantly associated with knowledge, whereas longer time on dialysis and complications negatively impact scores. 14 A more recent study undertaken by Ahsanuddin and colleagues 15 indicated that educational level and older age are independent risk factors for poor comprehension. However, both of these studies were conducted using tools that had not undergone formal psychometric testing.…”

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confidence: 99%

Development and Validation of the Kidney Transplant Understanding Tool (K-TUT)

Rosaasen

Taylor

Blackburn

et al. 2017

Transplantation Direct

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BackgroundSeveral educational interventions have been designed to improve patient knowledge before and after kidney transplantation. However, evaluation of such interventions has been difficult because validated instruments to measure knowledge-based outcomes in this population have not been developed.ObjectiveTo create a tool to measure patient knowledge of kidney transplantation and to evaluate its validity.MethodsThe Kidney Transplant Understanding Tool (K-TUT) was created using a stepwise iterative process. Experts in the field and transplant recipients were consulted to establish content validity. The K-TUT consists of 9 true/false and 13 multiple-choice questions, and scores are based on the number correct answers [YES/NO format] of 69 items. The questionnaire was piloted in a study that also measured health literacy (via the Short Test of Functional Health Literacy) in transplant candidates, whereas the main survey was mailed to transplant recipients. Test-retest was performed, and completed surveys were analyzed for internal consistency, construct validity, floor and ceiling effects, and reproducibility.ResultsSurveys were offered to 106 pretransplant patients and 235 in the posttransplant period, and response rates were 38.7% (41/106) and 63.4% (149/235), respectively. The mean corrected scores were 53.1 ± 8.5 (77%) and 56.2 ± 6.3 (81%), respectively. Test-retest was performed over 20% of both cohorts and percent agreement ranged between 70% and 100% in the pretransplant group and 66% and 100% in the posttransplant group. Cronbach α ranged from 0.794 to 0.875 in all cohorts indicating favorable internal consistency. Increased health literacy in the pretransplant group was significantly associated with increased knowledge (r = 0.52; P < 0.001), suggestive of construct validity, and the absence of floor and ceiling effects was positive. The majority of transplant recipients (98/148, 67%) believed the questionnaire adequately assessed transplant knowledge, about a quarter (36/148, 24.3%) were “unsure,” and 85% (126/148) agreed that no questions should be removed.ConclusionsAlthough more study is warranted to further assess psychometric properties, the K-TUT appears to be a promising tool to measure transplant knowledge.

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Geospatial Analysis of Organ Transplant Referral Regions

et al. 2022

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IMPORTANCESystem and center-level interventions to improve health equity in organ transplantation benefit from robust characterization of the referral population served by each transplant center. Transplant referral regions (TRRs) define geographic catchment areas for transplant centers in the US, but accurately characterizing the demographics of populations within TRRs using US Census data poses a challenge. OBJECTIVE To compare 2 methods of linking US Census data with TRRs-a geospatial intersection method and a zip code cross-reference method. DESIGN, SETTING, AND PARTICIPANTS This cohort study compared spatial congruence of spatial intersection and zip code cross-reference methods of characterizing TRRs at the census block level. Data included adults aged 18 years and older on the waiting list for kidney transplant from 2008 through 2018. EXPOSURES End-stage kidney disease. MAIN OUTCOMES AND MEASURESMultiple assignments, where a census tract or block group crossed the boundary between 2 hospital referral regions and was assigned to multiple different TRRs; misassigned area, the portion of census tracts or block groups assigned to a TRR using either method but fall outside of the TRR boundary. RESULTSIn total, 102 TRRs were defined for 238 transplant centers. The zip code cross-reference method resulted in 4627 multiple-assigned census block groups (representing 18% of US land area assigned to TRRs), while the spatial intersection method eliminated this problem. Furthermore, the spatial method resulted in a mean and median reduction in misassigned area of 65% and 83% across all TRRs, respectively, compared with the zip code cross-reference method. CONCLUSIONS AND RELEVANCEIn this study, characterizing populations within TRRs with census block groups provided high spatial resolution, complete coverage of the country, and balanced population counts. A spatial intersection approach avoided errors due to duplicative and incorrect assignments, and allowed more detailed and accurate characterization of the sociodemographics of populations within TRRs; this approach can enrich transplant center knowledge of local referral populations, assist researchers in understanding how social determinants of health may factor into access to transplant, and inform interventions to improve heath equity.

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Candidate Comprehension of Key Concepts in Kidney Transplantation

Abstract: Educational level and older age are independent risk factors for poor comprehension. Kidney candidate knowledge of organs with increased risks is suboptimal despite previous consent to receive such organs.

Cited by 15 publications

References 0 publications

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Development and Validation of the Kidney Transplant Understanding Tool (K-TUT)

Geospatial Analysis of Organ Transplant Referral Regions

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