A Mixed-Methods Approach to Understanding Variation in Social Support Requirements and Implications for Access to Transplantation in the United States
| Autor: | Douglas W. Hanto, Satia A. Marotta, Norman Daniels, Keren Ladin, Tara A. Lavelle, Zeeshan Butt, Elisa J. Gordon |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Social Workers Friends Transportation 030230 surgery 0603 philosophy ethics and religion Health Services Accessibility 03 medical and health sciences Social support 0302 clinical medicine Residence Characteristics Surveys and Questionnaires Activities of Daily Living Health care Financial Support Humans Psychology Medicine Family Practice Patterns Physicians' Psychiatry Response rate (survey) Transplantation Social work business.industry Patient Selection Health services research Social Support Organ Transplantation 06 humanities and the arts United States Family medicine Housing Female 060301 applied ethics business Psychosocial Health care quality |
| Zdroj: | Progress in Transplantation. 29:344-353 |
| ISSN: | 2164-6708 1526-9248 |
| DOI: | 10.1177/1526924819874387 |
| Popis: | Social support is a key component of transplantation evaluation in the United States. Social support definitions and evaluation procedures require examination to achieve clear, consistent implementation. We surveyed psychosocial clinicians from the Society for Transplant Social Workers and American Society of Transplant Surgeons about their definitions and evaluation procedures for using social support to determine transplant eligibility. Bivariate statistical analysis was used for quantitative data and content analysis for qualitative data. Among 276 psychosocial clinicians (50.2% response rate), 92% had ruled out patients from transplantation due to inadequate support. Social support definitions varied significantly: 10% of respondents indicated their center lacked a definition. Key domains of social support included informational, emotional, instrumental, motivational, paid support, and the patient’s importance to others. Almost half of clinicians (47%) rarely or never requested second opinions when excluding patients due to social support. Confidence and perceived clarity and consistency in center guidelines were significantly associated with informing patients when support contributed to negative wait-listing decisions ( P = .001). Clinicians who excluded fewer patients because of social support offered significantly more supportive health care ( P = .02). Clearer definitions and more supportive care may reduce the number of patients excluded from transplant candidacy due to inadequate social support. |
| Databáze: | OpenAIRE |
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