Trends in African Americans' Attitudes and Behaviors About Living Donor Kidney Transplantation.
Helene Vilme, Clemontina A Davenport, Jane Pendergast and 1 others
PMID 30229693WHAT IT FOUND
More dialysis or transplant exposure did not raise interest in living donor kidney transplant.
African American patients not yet on dialysis were interested (62.9%), but 54.8% had taken no steps. Action increased with exposure, not knowledge or trust.
Key findings
01Interest in living donor kidney transplant was high in all three groups (62.9% predialysis, 67.4% dialysis, 74.2% wait-list), but the upward trend across groups was not significant (P = .14).
02Pursuit of living donor kidney transplant increased with greater exposure to dialysis or transplant settings: 54.8% of predialysis patients and 27.2% of dialysis patients had completed no behaviors.
03Factual knowledge, health literacy, and trust in care were not associated with interest or pursuit of living donor kidney transplant in any cohort.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Each cohort was relatively small, and participants came from selected clinical settings and geographic locations, so results may not apply to all African American patients with advanced kidney disease. The analyses were cross-sectional, so they cannot show that exposure to dialysis or transplant causes pursuit, or that knowledge, literacy, or trust cause interest or action. The number analysed in the transplant wait-list cohort is not stated in the article text. The knowledge questions measured factual knowledge, not experience with dialysis or transplant, so they may not capture knowledge that matters for action.
Declared interests
The authors declared no potential conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that knowledge, health literacy, or trust are the main barriers to pursuing living donor kidney transplant. This paper found no significant association between those factors and interest or pursuit, and it was cross-sectional, so it cannot show that changing them would increase transplant steps.