Short-term impact of an educational program promoting live donor kidney transplantation in dialysis centers

Prog Transplant. 2008 Dec;18(4):263-72.

Abstract

Context: Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT).

Objective: To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. DEGISN: Baseline data and data from 1 week after interventions were analyzed.

Participants: 214 transplant-eligible hemodialysis patients attending 14 dialysis facilities in Maryland, Virginia, and Pennsylvania.

Interventions: In the basic intervention, 107 patients watched a 10-minute videotape on the experience of recipients and live donors of a kidney. In the enhanced intervention, 107 patients watched the same videotape and had a discussion with a health educator on the risks and benefits of LDKT, who could be a donor, and how to address the barriers they were encountering when seeking a live kidney donor.

Main outcome measure: Patient reported whether they were considering LDKT, had talked with family or friends about LDKT, and had asked someone for a kidney.

Results: Over half of transplant-eligible patients were not pursuing LDKT at baseline (64% in the basic intervention group, 61% in the enhanced intervention group). One week after the intervention, the odds of considering LDKT were higher among African Americans (odds ratio [OR], 2.28; confidence interval [CI], 1.22-4.25), younger patients (OR, 0.94; CI, 0.91-0.97), and patients who spent less time on dialysis (OR, 0.90; CI, 0.83-0.97). The odds of asking for a kidney were higher among African Americans (OR, 4.94; CI, 2.54-9.60) and patients who perceived they were in poor to fair health (OR, 3.30; CI, 1.12-9.67).

Conclusions: Although both interventions helped patients consider LDKT and ask for a kidney, more time and expanded educational content might be needed to facilitate patients' discussion about LDKT with their loved ones.

Publication types

  • Evaluation Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Attitude to Health*
  • Curriculum
  • Family
  • Female
  • Friends
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Intention
  • Kidney Transplantation / psychology*
  • Living Donors / psychology
  • Living Donors / supply & distribution*
  • Logistic Models
  • Male
  • Maryland
  • Middle Aged
  • Multivariate Analysis
  • Patient Education as Topic / organization & administration*
  • Pennsylvania
  • Program Evaluation
  • Renal Dialysis / psychology*
  • Time Factors
  • Tissue and Organ Procurement / organization & administration*
  • Videotape Recording
  • Virginia