Self-Care & Outcomes Among Kidney Transplant Recipients

自理

• 批准号: 7278762
• 负责人: Elisa J Gordon
• 金额: $ 11.65万
• 依托单位: ALBANY MEDICAL COLLEGE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7278762
• 关键词: Acute; African American; Attention; Attitude; Belief; Data; Data Analyses; Data Collection; Decision Making; Economics; Education; End stage renal failure; Ensure; Ethnic Origin; Financial Support; Goals; Graft Survival; Half-Life; Health; Health Policy; Immunosuppression; Immunosuppressive Agents; Insurance Carriers; Insurance Coverage; Interdisciplinary Study; Intervention; Interview; Kidney; Kidney Transplantation; Lead; Life; Literature; Longitudinal Studies; Measures; Medical; Medicare; Methods; Outcome; Patients; Policies; Policy Maker; Population; Process; Race; Renal function; Research; Research Personnel; Resources; Scientific Advances and Accomplishments; Self Care; Self Care outcome; Shapes; Social support; Support Groups; Survival Rate; Therapeutic immunosuppression; Transplant Recipients; Transplantation; Work; base; design; disability; health belief; improved; prevent; programs; racial and ethnic; social; socioeconomics; symptom management; wasting

DESCRIPTION (provided by applicant): Kidney loss in the first 10 years following transplantation remains a significant problem despite tremendous scientific advances in treating acute rejection and immunosuppression. This problem is pressing because racial/ethnic and socioeconomic disparities persist in kidney survival rates causing inequities in graft outcomes. One possible explanation for this survival difference is social inequities in self-care practices of compliance and symptom management. Self-care is essential to the survival of the kidney. But the resources (e.g., financial, social support) for self-care are not equitably distributed in the population. Under the new 2001 Medicare bill (HR 4577), only kidney recipients with disabilities obtain full support for as long as the new kidney functions, but most kidney recipients do not have disabilities, so financial support remains limited. This limitation can lead to the waste of scarce kidneys because it prevents patients from sustaining their kidneys after three years. Consequently, the capacity for and practice of self-care varies by race/ethnicity and insurance status. The proposed interdisciplinary study will examine the social, cultural, and economic strategies and resources that kidney recipients mobilize to keep their kidneys healthy in the context of limited financial support from insurers. The specific aims of this study are to: 1) examine transplant recipients' health beliefs about kidney survival, compliance, and rejection; 2) investigate transplant recipients' practices of self-care and financially maintaining a kidney transplant; 3) measure the impact of recipients' health beliefs and self-care practices on graft outcomes; and 4) compare self-care practices and graft outcomes among kidney recipients with different demographic and socioeconomic backgrounds. To accomplish these goals, the proposed four-year longitudinal study will use a multi-method approach for data collection. Data will be gathered prospectively through interviews with kidney recipients every six months and through medical chart review. Identifying the sociocultural and economic processes associated with better graft survival is important for: a) preventing kidney rejection, b) devising compliance interventions, c) preparing candidates for transplant through education, d) evaluating health policies designed to prevent financial barriers to kidney transplantation, and e) eliminating disparities in long-term kidney survival rates

描述（由申请人提供）：

项目成果

The ethics of withdrawal from study participation.

退出研究参与的道德规范。

• DOI: 10.1080/08989620600848645
• 发表时间: 2006
• 期刊: Accountability in research
• 作者: Gordon,ElisaJ;Prohaska,ThomasR
• 通讯作者: Prohaska,ThomasR

Beyond the basics: designing a comprehensive response to low health literacy.

超越基础：设计针对低健康素养的综合应对措施。

• DOI: 10.1080/15265160701638538
• 发表时间: 2007
• 期刊: The American journal of bioethics : AJOB
• 作者: Gordon,ElisaJ;Wolf,MichaelS
• 通讯作者: Wolf,MichaelS

Health literacy skills of kidney transplant recipients.

肾移植受者的健康素养技能。

• DOI: 10.1177/152692480901900104
• 发表时间: 2009
• 期刊: Progress in transplantation (Aliso Viejo, Calif.)
• 作者: Gordon,ElisaJ;Wolf,MichaelS
• 通讯作者: Wolf,MichaelS

Self-care strategies and barriers among kidney transplant recipients: a qualitative study.

• DOI: 10.1177/1742395309103558
• 发表时间: 2009-06
• 期刊: Chronic illness
• 影响因子: 1.3
• 作者: Gordon EJ;Prohaska TR;Gallant M;Siminoff LA
• 通讯作者: Siminoff LA

THE ETHICS OF MEDICARE POLICY: INCREASING TRANSPLANT ACCESS AND SURVIVAL.

医疗保险政策的道德：提高移植机会和生存率。

• 发表时间: 2006
• 期刊: De Paul law review
• 作者: Gordon,ElisaJ