Effectiveness of educational and social worker interventions to activate patients' discussion and pursuit of preemptive living donor kidney transplantation: a randomized controlled trial
| Autor: | Boulware, L Ebony, Hill-Briggs, Felicia, Kraus, Edward S, Melancon, J Keith, Falcone, Brenda, Ephraim, Patti L, Jaar, Bernard G, Gimenez, Luis, Choi, Michael, Senga, Mikiko, Kolotos, Maria, Lewis-Boyer, LaPricia, Cook, Courtney, Light, Laney, DePasquale, Nicole, Noletto, Todd, Powe, Neil R |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Social Work Tissue and Organ Procurement Kidney Disease Clinical Trials and Supportive Activities Clinical Sciences Renal and urogenital Live kidney transplantation Patient Education as Topic 7.1 Individual care needs Clinical Research live kidney donation Behavioral and Social Science Living Donors Humans Renal Insufficiency Chronic Aged social worker Transplantation education Prevention Organ Transplantation Middle Aged Urology & Nephrology Kidney Transplantation Public Health and Health Services Female Management of diseases and conditions Attitude to Health chronic kidney disease |
| Zdroj: | American journal of kidney diseases : the official journal of the National Kidney Foundation, vol 61, iss 3 |
| Popis: | BackgroundMany patients with chronic kidney disease (CKD) have difficulty becoming actively engaged in the pursuit of preemptive living donor kidney transplantation.Study designThe Talking About Live Kidney Donation (TALK) Study was a randomized controlled trial of the effectiveness of educational and social worker interventions designed to encourage early discussions and active pursuit of preemptive living donor kidney transplantation in patients with progressive CKD.Setting & participantsWe recruited participants with progressive CKD from academically affiliated nephrology practices in Baltimore, MD.InterventionParticipants randomly received: (1) usual care (routine care with their nephrologists), the (2) TALK education intervention (video and booklet), or the (3) TALK social worker intervention (video and booklet plus patient and family social worker visits).OutcomesWe followed participants for 6 months to assess their self-reported achievement of behaviors reflecting their discussions about and/or pursuit of living donor kidney transplantation (discussions with family, discussions with physicians, initiating recipient evaluation, completing recipient evaluation, and identifying a potential living donor).MeasurementsWe assessed outcomes through a questionnaire at 1-, 3-, and 6-months follow-up.ResultsParticipants receiving usual care with their nephrologists (n = 44), TALK education (n = 43), and the TALK social worker (n = 43) were similar at baseline. TALK Study interventions improved participants' living donor kidney transplantation discussion and pursuit behaviors, with the social worker leading to greater patient activation (participants' predicted probability of achieving living donor kidney transplantation discussions, evaluations, or donor identification over 6 months): probabilities were 30% (95% CI, 20%-46%), 42% (95% CI, 33%-54%), and 58% (95% CI, 41%-83%), respectively, in the usual care, TALK education, and TALK social worker groups (P = 0.03).LimitationsOur population was well educated and mostly insured, potentially limiting generalizability of our findings.ConclusionsTALK interventions improved discussion and active pursuit of living donor kidney transplantation in patients with progressive CKD and may improve their use of preemptive living donor kidney transplantation. |
| Databáze: | OpenAIRE |
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