Contextual Basis for a New Educational Intervention on Living Kidney Donation and Transplant for American Indians

Purpose:

American Indians disproportionately experience numerous chronic health conditions that contribute to renal disease and failure. Prior to this study, there were no known empirically-tested educational programs on living kidney donation and transplantation (LKDT) designed for American Indians who experience renal failure and who may be eligible for a kidney transplant. The purpose of this study was to qualitatively explore the contextual factors impact LKDT attitudes and educational needs among American Indians. Findings informed the development and future testing of a LKDT educational intervention.

Methods:

The study used a community based participatory research approach and was guided by both a community and a clinical advisory board. The method of qualitative description was employed to elucidate the factors that influence LKDT education for the intended population. Individual interviews with five American Indian participants who were receiving renal dialysis but who were not yet evaluated for renal transplant were conducted. A scripted guide was used and interviews were conducted by a trained data collector who was an American Indian health professional. Transcribed recordings were analyzed using the constant comparative technique. Community advisory board members reviewed and validated the findings as reported by two independent data analysts who merged their findings.

Results:

Overall themes that emerged from the analysis included: a cautious approach toward living kidney donation and transplant conversations, a concern for others, and expectations for culturally-sensitive education. Community advisory members confirmed the findings and conveyed an urgent need for education on renal disease and both living and deceased kidney donation and transplant.

Conclusions:

Culturally-sensitive education on kidney donation and transplantation is needed for American Indians and interventions should include stories of community members and convey a message of hope in addition to basic education about kidney disease, the benefits of kidney transplant, and information about donor risks ad benefits.