Interpretative Phenomenological Study Exploring Why People With Kidney Failure Say 'No' to a Kidney Transplant.

The study describes experiences and reasons, not whether a different approach would change transplant uptake or improve patient outcomes. People were interviewed once, so the study cannot show how transplant decisions change over time, although some said they might reconsider later. Most participants were White British, so cultural, religious and spiritual influences on declining transplant may be underrepresented. The study was done in the UK NHS, where healthcare is funded by taxation, so findings may not transfer directly to insurance-based systems. Family members and healthcare professionals were not included, so the social and clinical context around these decisions is only partly described. Participants declined transplant at different points in the kidney pathway, including before full assessment, so the group was not a uniform set of listed candidates.

The authors declare no conflicts of interest. Funding is named as KESS 2.

Do not conclude that kidney transplant is the wrong treatment or that nurses should stop discussing it. This qualitative study reports why some people declined and how pressure harmed trust; it does not compare outcomes of dialysis and transplant or test whether better education would change decisions.