Preferences, knowledge, communication and patient-physician discussion of living kidney transplantation in African American families

被引:77
作者
Boulware, LE [1 ]
Meoni, LA
Fink, NE
Parekh, RS
Kao, WHL
Klag, MJ
Powe, NR
机构
[1] Johns Hopkins Sch Med, Dept Med, Baltimore, MD USA
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA
[4] Johns Hopkins Sch Med, Dept Pediat, Baltimore, MD USA
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA
[6] Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD USA
关键词
living kidney transplantation; communication; families; patient-physician discussion;
D O I
10.1111/j.1600-6143.2005.00860.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
It is unknown whether patient-physician discussion about live kidney transplantation (LT) among African Americans (AA) is affected by preferences, knowledge and family discussions regarding LT. We recruited 182 AA dialysis patients and their families and assessed the relation of preferences, knowledge and family discussions regarding LT to the occurrence of patient-physician discussion using multivariable logistic regression. Most patients (76%) desired a transplant, and most patients (93%), spouses (91%) and children (88%) had knowledge of LT. Nearly half of the families discussed transplantation. Only 68% of patients and less than half of their spouses (41%) and children (31%) had discussed transplantation with physicians. Patient-physician discussion was more common among patients: whose spouses acknowledged their interest in transplantation (adjusted odds ratio (AOR) (95% CI):3.5 (1.61-7.8)); who discussed transplantation with spouses (AOR(95% CI):5.25 (2.22-12.41)); whose spouses agreed that they discussed transplantation with patients (AOR (95%CI):5.20 (1.76-15.37)) and whose children discussed transplantation with patients' physicians (AOR (95%CI):7.4 (1.3-40.0)). Universal patient-physician discussion of LT does not occur despite patient preferences. Rates of family-physician discussions are low, and rates of family discussions vary. Early family-physician discussion of LT, use of allied health professionals to promote family discussion of LT and the institution of culturally appropriate programs to enhance discussion of LT in AA families could improve rates of discussion and enhance patients' access to LT.
引用
收藏
页码:1503 / 1512
页数:10
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