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Patient attitudes towards kidney transplant listing : qualitative findings from the ATTOM study
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Calestani, M., Tonkin-Crine, S., Pruthi, R., Leydon, G., Ravanan, R., Bradley, J. A., Tomson, C. R., Forsythe, J. L., Oniscu, G. C., Bradley, C., Cairns, J., Dudley, C., Watson, C., Draper, Heather, Johnson, R. J., Metcalfe, W., Fogarty, D. G. and Roderick, P. (2014) Patient attitudes towards kidney transplant listing : qualitative findings from the ATTOM study. Nephrology Dialysis Transplantation, 29 (11). pp. 2144-2150. doi:10.1093/ndt/gfu188 ISSN 0931-0509.
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Official URL: http://dx.doi.org/10.1093/ndt/gfu188
Abstract
Background There is variation in time to listing and rates of listing for transplantation between renal units in the UK. While research has mainly focused on healthcare organization, little is known about patient perspectives of entry onto the transplant waiting list. This qualitative study aimed to explore patients' views and experiences of kidney transplant listing.
Methods Semi-structured interviews were conducted with patients aged under 75, who were on dialysis and on the transplant waiting list, not on the waiting list, undergoing assessment for listing or who had received a transplant. Patients were recruited from a purposive sample of nine UK renal units, which included transplanting and non-transplanting units and units with high and low wait-listing patterns. Interviews were transcribed verbatim and analysed using thematic analysis.
Results Fifty-three patients (5–7 per renal unit) were interviewed. Patients reported that they had received little information about the listing process. Some patients did not know if they were listed or had found they were not listed when they had thought they were on the list. Others expressed distress when they felt they had been excluded from potential listing based on age and/or comorbidity and felt the process was unfair. Many patients were not aware of pre-emptive transplantation and believed they had to be on dialysis before being able to be listed. There was some indication that pre-emptive transplantation was discussed more often in transplant than non-transplant units. Lastly, some patients were reluctant to consider family members as potential donors as they reported they would feel ‘guilty’ if the donor suffered subsequent negative effects.
Conclusions Findings suggest a need to review current practice to further understand individual and organizational reasons for the renal unit variation identified in patient understanding of transplant listing. The communication of information warrants attention to ensure patients are fully informed about the listing process and opportunity for pre-emptive transplantation in a way that is meaningful and understandable to them.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Nephrology Dialysis Transplantation | ||||||||
| Publisher: | Oxford University Press | ||||||||
| ISSN: | 0931-0509 | ||||||||
| Official Date: | 4 June 2014 | ||||||||
| Dates: |
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| Volume: | 29 | ||||||||
| Number: | 11 | ||||||||
| Page Range: | pp. 2144-2150 | ||||||||
| DOI: | 10.1093/ndt/gfu188 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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