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Title: A better life after transplant or fear of death?: A decisional balance analysis of living donor kidney transplant readiness
Authors: Rafiqzad, H., Wasim, A., Rezaeishahreza, A., Lam, J., Li, A., Mahiuddin, T., Waterman, A., Novak, M., Mucsi, I.
Year: 2020
Conference: European Association of Psychosomatic Medicine 2022
Full Abstract* We assessed whether the importance attributed to “living a longer life with transplant” versus “fear of death during transplant surgery” by KT candidates was associated with readiness to explore living donor kidney transplant (LDKT). Adults on dialysis in Toronto rated the importance of presumed positive and negative outcomes of KT (‘not important’ to ‘extremely important’) on an electronic data capture platform. KT pro and con scores were calculated by summing item scores. Answers to items of interest (“I would live a longer life with a transplant”; “I could die during the transplant surgery”) were dichotomized (not/slightly/moderately vs very/extremely important) to assess their association with outcome. LDKT readiness (outcome) was categorized: “taking actions to explore LDKT” vs “considering/not considering LDKT”. Of 576 participants (63% male, mean[SD] age 57[13] years) 87% considered living a longer life after KT as highly important, while only 37% considered potential death during surgery as highly important to their KT decision. In multivariable adjusted logistic regression, individuals for whom “living a longer life …” was of high importance were more likely to be taking LDKT actions (OR=2.61, CI=1.13-6.03, P=0.03). In a similar model, the importance of potential death during surgery was not associated with LDKT readiness (OR=0.71, CI=0.45-1.13, P=0.15). Individuals motivated by positive outcomes of LDKT, were more likely to take LDKT actions. Negative consequences, including fear of death were not associated with LDKT readiness. As predicted by the Transtheoretical Model, understanding LDKT readiness and emphasizing the potential positive outcomes may motivate patients to explore LDKT.
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