Racial differences in coping with the need for kidney transplantation and willingness to ask for live organ donation
Racial differences in coping with the need for kidney transplantation and willingness to ask for live organ donation
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DOI：
10.1053/j.ajkd.2005.10.018
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发表时间：
2006-02-01
影响因子：
13.2
通讯作者：
Baliga, PK
中科院分区：
文献类型：
--
作者：
Lunsford, SL;Simpson, KS;Baliga, PK
背景非洲裔美国人活体供肾移植的差异继续增长。患者如何科普终末期肾病的现实以及随后的透析或肾移植需求可能直接影响他们的疾病过程，生活质量和要求活体肾脏捐赠的意愿。种族差异的应对可能存在，并涉及到愿意要求活体肾脏捐赠。方法：对潜在的肾移植受者前瞻性地使用简明科普和活体器官捐献者调查工具。14种不同的应对机制进行了种族分析，以寻找差异。自愿要求活体肾脏捐赠进行了分析，以寻找可能的相关性与应对机制和可能的预测因素进行了Logistic回归分析。结果：333名潜在的肾移植受者进行了调查，61%的非洲裔美国人。种族差异表现在以下应对机制：接受、幽默、宗教、否认和行为脱离。虽然种族差异并不存在整体意愿要求捐赠，积极的应对策略与要求捐赠的意愿增加。结论：非裔美国人科普肾移植的需要不同于非裔美国人。潜在的非洲裔美国人肾脏接受者更有可能否认移植的必要性，并且不太接受他们的情况。这可能会影响他们对移植需要的看法，以及他们要求活体捐赠的说服力。移植计划应确保咨询和教育计划的目的是修改不切实际的期望，提高受体的应对技能。
Background. Disparities in African-American live donor kidney transplantation continue to grow. How patients cope with the reality of end-stage renal disease and the ensuing need for dialysis or a kidney transplant may directly affect the course of their disease, quality of life, and willingness to ask for live kidney donation. Racial differences in coping may exist and relate to the willingness to ask for live kidney donation. Methods: The Brief COPE and Living Organ Donor Survey instruments were administered prospectively to potential kidney transplant recipients. The 14 different coping mechanisms were analyzed by race to look for differences. Willingness to ask for live kidney donation was analyzed to look for possible correlations with coping mechanisms and possible predictors analyzed by means of logistic regression. Results: Three hundred thirty-three potential kidney transplant recipients were administered the surveys, with 61% African Americans. Racial differences were seen in the following coping mechanisms: acceptance, humor, religion, denial, and behavioral disengagement. Although racial differences did not exist in overall willingness to ask for donation, positive coping strategies were related to increased willingness to ask for donation. Conclusion: African Americans cope with the need for a kidney transplant differently than non-African Americans. Potential African-American kidney recipients are more likely to deny the need for a transplant and are less accepting of their situation. This may affect their perception of the need for transplantation and their persuasiveness in asking for live donations. Transplant programs should ensure that counseling and education programs aim to modify unrealistic expectations and improve recipient coping skills.