Using Focus Groups to Understand Dialysis Staff Perspectives on Delivering Transplant Education

Abstract

Introduction Kidney transplant education in dialysis facilities could be optimized with internet resources, like videos, but most qualitative research predates widespread availability of online video education about kidney transplantation. To improve understanding of dialysis staff transplant education practices, as well as the potential value of video, we conducted focus groups of dialysis center staff members in Buffalo, NY. Methods/Approach Seventeen focus groups (97 participants: 53 nurses, 10 dialysis technicians, 6 social workers, 6 dieticians, 7 administrative personnel, 2 trainees, and 1 insurance coordinator) from 8 dialysis facilities in Buffalo, NY, were conducted, audio-recorded, transcribed, and analyzed. After thematic data analysis, a diverse patient and caregiver community advisory board was invited to comment, and their voices were integrated. Findings: Five key themes were identified that captured barriers to transplant education delivery and how online video could be a facilitator: (1) delivery of transplant education was reliant on one person, (2) other dialysis staff had time to answer transplant questions but felt uninformed, (3) patient lack of interest in existing supplementary transplant education, (4) patient disinterest in transplantation education was due to education timing, feeling overwhelmed, and transplant fear/ambivalence, and (5) video education could be flexible, low effort, and spark transplant interest. Study limitations are potential selection bias and inclusion of English-speaking participants only. Discussion Dialysis staff barriers of time, insufficient knowledge, and limited resources to provide education to patients and their care partners may be mitigated with online educational videos without increasing staff workload.

Preliminary feasibility of animated video education designed to empower patients’ referral to kidney transplantation

“…Research on the use of animations in advertising 34 suggests that ratings of favorability and level of attention beget learning gains when viewing animated videos versus static text information. Appealing content that can be learned without supervision has great potential to be used in busy clinical sites and to reach a broad spectrum of viewers seeking to learn independently 12 …”

“…Appealing content that can be learned without supervi-sion has great potential to be used in busy clinical sites and to reach a broad spectrum of viewers seeking to learn independently. 12…”

“…Low referral is generated, in part, by patient knowledge gaps and fears of transplant, and poor patient‐provider communication 6,7 . Transplant education influences receptivity of kidney failure patients to transplant and referral for transplantation, 8–10 yet adequate education may not be provided, 11 perhaps because the available educational resources are time intensive for providers to deliver and not appealing or accessible to patients 12 …”

“…receptivity of kidney failure patients to transplant and referral for transplantation, 8-10 yet adequate education may not be provided, 11 perhaps because the available educational resources are time intensive for providers to deliver and not appealing or accessible to patients. 12 Animated video is a powerful medium to deliver information and can be deployed as standalone education. [13][14][15][16][17] Animated video can bring education to people and is easy for anyone to deliver, including administrative staff and lay intermediaries; it can also greatly improve the quality of information while addressing many of the root causes for poor information access, such as language and literacy barriers.…”

Using Community-Based Participatory Research to Create Animated Videos to Attenuate Disparities in Access to Kidney Transplant Information

“…6 Intervention effects are lower in difficult-to-reach populations, 7 perhaps because they require physical or scheduled visits and have limited patient interest. 8, 9 Animated video can bring education to people and can greatly improve the quality of information while addressing many of the root causes for disparities, such as language and literacy barriers. Community-based participatory research (CBPR) may increase the efficacy of interventions by engaging community partners to ensure that the intervention is culturally appropriate, beneficial to the users, and easy to use and understand.…”