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Challenges in decision-making support processes regarding living kidney donation: A qualitative study.
Yuri Wada1, Takayoshi Ueno1, Koji Umeshita1
1Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Journal of Renal Care
|April 10, 2024
Summary
Supporting living kidney donor autonomy requires addressing coordinator challenges. Experienced coordinators with strong communication skills are crucial for ethical decision-making support in living donor kidney transplantation.
Area of Science:
- Transplantation Medicine
- Bioethics
- Healthcare Professional Training
Background:
- Living kidney donor decision-making is complex, with potential threats to donor autonomy.
- Effective decision-making support is vital to protect living kidney donor candidates' autonomy.
Purpose of the Study:
- Identify challenges faced by clinical transplant coordinators in supporting living donor autonomy.
- Determine strategies for overcoming these challenges in living donor kidney transplantation.
Main Methods:
- Qualitative descriptive study design.
- Semi-structured interviews with ten clinical transplant coordinators.
- Modified grounded theory approach for data analysis.
Main Results:
- Difficulties include interpersonal dynamics, environmental/institutional factors, and coordinator emotional labor.
- Methods involve experienced-based assessment, family interventions, inter-staff coordination, assertive communication, and donor protection.
Conclusions:
- Highly experienced coordinators with strong communication and reflective skills are essential.
- The transplant community's inherent power dynamics may require fundamental review to ensure donor autonomy.
