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Patient Attitudes Toward Transplantation as Preferred Treatment Modality in Different Stages of Renal Disease
1Division of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
Objective:
Kidney transplantation is generally considered to be the best treatment for end-stage renal disease. Not every patient can be operated, but many of suitable patients refuse this possibility. We aimed to explore the attitudes of patients with chronic kidney disease towards renal replacement therapies to recognize motives, thoughts, and feelings concerning accepting or refusing the treatment. We studied the attitudes towards the illness and the treatment, the appearance of depression, and the disease burden during different stages of the disease.
Methods:
For this study we implemented a questionnaire that we developed (which has been described in an earlier publication of this journal) with 99 pre-dialysis patients, 99 dialysis patients, and 87 transplantation patients. We completed the attitude questionnaire designed by our team to include disease burden and depression questionnaires.
Results:
We used discriminant analysis to describe different stages of the disease. There was a significant difference in the following factors between the three patient groups: accepting the new kidney, lack of confidence in transplantation therapy, fear of surgery, accepting self-responsibility in recovery, dependency on the transplanted kidney, confidence in recovery, subjective burden of dialysis, and denial of personal responsibility in maintaining the transplanted kidney. Significant differences were also detected in these three groups regarding the level of depression and disease burden: we measured the highest value among the dialysis patients, and the lowest value among the pre-dialysis patients. Comparing patients accepting and refusing transplantation, we found a correlation between the refusal of transplantation and the attitudes towards the illness and treatment.
Conclusions:
Most patients remain unmotivated to change treatment modality and refuse transplantation. Misbelief about transplantation shows a correlation with the motive of refusal. Dissemination of information may facilitate a change in the situation.
Insights
Many patients with end-stage renal disease refuse kidney transplantation due to misbeliefs and negative attitudes towards the procedure. Addressing these concerns through better information may improve treatment acceptance for chronic kidney disease patients.
Area of Science:
- Nephrology
- Transplantation Medicine
- Patient Psychology
Background:
- Kidney transplantation is the optimal treatment for end-stage renal disease (ESRD).
- A significant number of eligible patients decline transplantation.
- Understanding patient attitudes towards renal replacement therapies is crucial.
Purpose of the Study:
- To explore patient attitudes towards renal replacement therapies.
- To identify motives, thoughts, and feelings influencing acceptance or refusal of kidney transplantation.
- To assess attitudes towards illness, treatment, depression, and disease burden across ESRD stages.
Main Methods:
- A developed questionnaire was administered to 99 pre-dialysis, 99 dialysis, and 87 transplantation patients.
- The study included attitude, disease burden, and depression questionnaires.
- Discriminant analysis was used to differentiate between patient groups.
Main Results:
- Significant differences were found in confidence in transplantation, fear of surgery, and responsibility perceptions between patient groups.
- Dialysis patients reported the highest depression and disease burden, while pre-dialysis patients reported the lowest.
- Refusal of transplantation correlated with negative attitudes towards illness and treatment.
Conclusions:
- Most patients are unmotivated to switch from dialysis and refuse transplantation.
- Misbeliefs about transplantation are linked to refusal motives.
- Improved information dissemination could enhance treatment acceptance.
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