A Mixed Methods Approach to Understand Donor Choice

了解捐助者选择的混合方法

• 批准号: 8702950
• 负责人: SALLY L Maliski
• 金额: $ 23.1万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8702950
• 关键词: Acculturation; Address; Advocate; Anxiety; Belief; Blood typing procedure; California; Characteristics; Communities; Comorbidity; Decision Making; Demographic Aging; Development; Dialysis procedure; Education; Educational Materials; Emotional; Employee Strikes; End stage renal failure; Ethnic Origin; Family; Family member; Foundations; Friends; Gender; Health; Individual; Insurance Coverage; Interview; Kidney; Kidney Transplantation; Life; Living Donors; Measures; Mental Depression; Mental Health; Methods; Occupations; Organ; Organ Donor; Outcome; Participant; Patients; Pattern; Pilot Projects; Positioning Attribute; Process; Quality of life; Recruitment Activity; Registries; Relative (related person); Religion; Rights; Solutions; Spottings; Survival Rate; Testing; Transplantation; United States; Waiting Lists; Work; demographics; experience; health related quality of life; income insurance; innovation; insight; interest; meetings; novel; novel strategies; operation; public health relevance; screening; tool; transplant registry

DESCRIPTION (provided by applicant): Kidney donation is life-saving for those with end-stage renal disease, providing the possibility of a relatively healthy and productive life. Unfortunately, there is a severe deficit in the number of donor kidneys relative to the number of patients in need. A novel approach to this situation has been the creation of transplantation chains triggered by non-directed (altruistic) donors. Transplantation chains are initiated when a non-directed (altruistic) donor donates a kidney to a patient who has a willing but incompatible donor. Once this recipient is transplanted, his or her original willing-incompatible donor - known as a bridge donor - then passes on the generosity to another recipient. Once the second recipient receives a transplant, their original incompatible donor likewise passes on the generosity to a third recipient. This process can be repeated for multiple iterations creating long chains of transplantations. The patients who receive transplants as part of chains are removed from the deceased donor waiting list, enabling other candidates to move up the waiting list and take their spots. This approach has potential to decrease the competition for deceased donor organs, easing the strain on the waiting list. Yet, very little is known about how non-directed (altruistic) donors and bridge donors make decisions about donating a kidney, nor about characteristics of potential donors who actually donate versus those who do not complete the donation process. Emerging themes from our pilot study suggest a need to further investigate the emotional journey of donors, especially post transplant. Striking patterns between donor demographics, strong health and quality of life outcomes, and specific beliefs are apparent. Therefore, this study utilizes a qualitative-dominant mixed methods approach to develop an explanatory framework for the decisional processes of non-directed donors and bridge donors. People who considered becoming non-directed (altruistic) donors or bridge donors but eventually decided against donating as well as actual non-directed (altruistic) donors and bridge donors will be recruited. Participants will complete an in-depth interview as well as quantitative measures of health related quality of life, anxiety, and depression. The development of the interview guide and selection of the quantitative measures will be informed by an advisory board of stakeholders in the kidney transplant community, including kidney donors and recipients, family members of kidney donor recipients, kidney donation advocates, and representatives from transplant registries. In an effort to ultimately expand the donor pool, results from this stuy will be the first to provide an in-depth description of potential and actual altruistic kidney donos that will provide the foundation upon which to develop educational materials for individuals contemplating kidney donation, create and test tools to identify those most likely to be successful altruistic donors, and to develop concepts and hypotheses to further explore this new and innovative phenomena.

描述（由申请人提供）：肾脏捐赠是针对末期肾脏疾病的人挽救生命的，这为相对健康和生产力的生活提供了可能性。不幸的是，相对于有需要的患者人数，供体肾脏数量严重缺陷。这种情况的一种新颖的方法是创建由非指导（无私）捐赠者触发的移植链的创建。当非指导（无私）供体向有愿意但不兼容供体的患者捐赠肾脏时，将开始移植链。一旦移植了这个接收者，他或她的原始愿意兼容的捐赠者（称为桥梁捐赠者）将慷慨大方传递给另一个收件人。一旦第二个接收者接收移植，他们的原始不兼容供体也将慷慨大方传递给第三个接受者。可以重复此过程，以使多个迭代产生长时间 移植链。接受移植作为链条一部分的患者将从已故的捐赠者等待名单中删除，使其他候选人能够上升名单并占据位置。这种方法有可能减少已故捐赠者器官的竞争，从而减轻候补名单上的压力。然而，对于非指导（无私的）捐助者和桥梁捐赠者如何做出捐赠肾脏的决定，对实际捐赠与未完成捐赠过程的潜在捐赠者的特征的决定鲜为人知。我们的试点研究的新兴主题表明，有必要进一步研究捐助者的情感旅程，尤其是移植后。显而易见的是，捐助者人口统计学，强大的健康和生活质量和特定信念之间的惊人模式显而易见。因此，本研究利用定性的混合方法方法来为非导向捐赠者和桥梁捐助者的决策过程开发解释性框架。考虑成为非指导（无私的）捐助者或桥梁捐助者但最终决定不捐款以及实际非指导（无私的）捐助者和桥梁捐助者的人。参与者将完成深入的访谈以及与健康相关的生活质量，焦虑和抑郁的定量衡量。面试指南的制定和定量措施的选择将由肾脏移植社区中的利益相关者咨询委员会告知，包括肾脏捐助者和接受者，肾脏捐助者接受者的家庭成员，肾脏捐赠倡导者以及移植注册的代表。为了最终扩大供体池，该Stuy的结果将是第一个提供对潜在和实际的无私肾脏供体的深入描述，这些肾脏将为个人捐赠，创建和测试工具提供教育材料的基础，以创建和测试工具，以确定最有可能成功地识别利润捐赠者，并开发概念和假设和假设和假设和假设和假设和新颖的现场。