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Fox DE, Hall M, Thibodeau C, Coldwell K, Lauder L, Dewell SL, Davidson SJ. The experiences of patients, caregivers and donors on transplant journeys in Canada: A convergent parallel mixed methods study. J Eval Clin Pract 2024; 30:268-280. [PMID: 38037502 DOI: 10.1111/jep.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The organ donation and transplantation (ODT) system in Canada is complex and can be challenging for individuals to navigate. We thus aimed to illuminate the experiences of individuals on transplant journeys using a patient-oriented convergent parallel mixed-methods approach. METHODS We captured data on adult patients, living donors, and caregivers on transplant journeys across Canada through an online survey (n = 935) and focus groups (n = 21). The survey was comprised of 48 questions about the individuals' experiences with the living donation and transplantation system, which were analyzed descriptively. Qualitative data were analyzed using an inductive conventional content analysis approach. RESULTS Most participants were female (70.1%), English speaking (92.6%) and White (87.8%). Participants' experiences were represented across six key themes: holistic person-centred care, accountable care, collective impact, navigating uncertainty, connection and advocacy. Quantitative and qualitative data were integrated to identify five opportunities to improve the organ donation and transplantation system in Canada: enhancing mental health support, establishing formal peer support programmes, improving continuity of care, improving knowledge acquisition, and expanding resources and support. CONCLUSION It is imperative that the ODT system commits to asking, listening, and learning from individuals on transplant journeys and to provide them opportunities to help improve it.
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Affiliation(s)
- Danielle E Fox
- Department of Community Health Sciences, The University of Calgary, Calgary, Alberta, Canada
| | - Marc Hall
- Faculty of Nursing, The University of Calgary, Calgary, Alberta, Canada
| | | | - Kristi Coldwell
- Transplant Research Foundation of British Columbia, Vancouver, British Columbia, Canada
| | - Lydia Lauder
- The Kidney Foundation of Canada, Montreal, Québec, Canada
| | - Sarah L Dewell
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Sandra J Davidson
- Faculty of Nursing, The University of Calgary, Calgary, Alberta, Canada
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Fox D, Hall M, Thibodeau C, Coldwell K, Lauder L, Dewell S, Davidson S. Impact of the COVID-19 pandemic on Canadian transplant journeys: a mixed methods study. BMJ Open 2023; 13:e068347. [PMID: 38040429 PMCID: PMC10693860 DOI: 10.1136/bmjopen-2022-068347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/20/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Navigating the organ donation and transplantation system in Canada can be challenging for individuals on transplant journeys. Although it is likely that the COVID-19 pandemic has further contributed to these challenges, the experiences of individuals during the pandemic in Canada have not been well elicited. OBJECTIVE To illuminate how the COVID-19 pandemic has impacted individuals on transplant journeys in Canada. DESIGN Convergent parallel mixed-methods study. SETTING Canada. PARTICIPANTS Adult patients, caregivers, and donors on transplant journeys across Canada. DATA COLLECTION Eight focus groups and an online survey between May and November 2021. Focus group transcripts were analysed using an inductive conventional content analysis approach. Survey data were analysed using descriptive statistics. The study was guided by individuals with lived experience of organ donation and transplantation. RESULTS A total of 830 participants completed three COVID-19 related survey questions, with 21 participating in the focus groups. Survey results: over 50% of patients and caregivers reported that the pandemic impacted their access to their healthcare team, their mental health (60% and 65%, respectively) and their comfort going out in public (80% and 75%, respectively). Although many donors reported several factors that impacted their transplant journey, the impact appeared to be greater for patients and caregivers. Qualitative results: three themes emerged from the qualitative data that contextualise participant's experiences: compounding isolation, disruption amid uncertainty and unforeseen benefits. CONCLUSION The COVID-19 pandemic has exacerbated many of the challenges that individuals on transplant journeys experience. It will be critical for transplant programmes to consider these factors in future care provision.
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Affiliation(s)
- Danielle Fox
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Marc Hall
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | - Kristi Coldwell
- Transplant Research Foundation of British Columbia, Vancouver, British Columbia, Canada
| | - Lydia Lauder
- Kidney Foundation of Canada, Montreal, Québec, Canada
| | - Sarah Dewell
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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Vinson AJ, Singh S, Chadban S, Cherney D, Gaber O, Gill JS, Helgeson E, Herzog CA, Jardine M, Jha V, Kasiske BL, Mannon RB, Michos ED, Mottl AK, Newby K, Roy-Chaudhury P, Sawinski D, Sharif A, Sridhar VS, Tuttle KR, Vock DM, Matas A. Premature Death in Kidney Transplant Recipients: The Time for Trials is Now. J Am Soc Nephrol 2022; 33:665-673. [PMID: 35292438 PMCID: PMC8970447 DOI: 10.1681/asn.2021111517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Amanda J Vinson
- Division of Nephrology, Department of Medicine, Nova Scotia Health Authority, Nova Scotia, Canada
| | - Sunita Singh
- Division of Nephrology, Department of Medicine, Ajmera Transplant Centre, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Steven Chadban
- Division of Nephrology, Department of Medicine, Kidney Centre, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia
| | - David Cherney
- Department of Medicine, University of Toronto, Toronto, Canada
- Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Osama Gaber
- Department of Surgery, Houston Methodist Hospital, Houston, Texas
- Department of Surgery, Weill Cornell Medicine, New York, New York
| | - John S Gill
- Division of Nephrology, University of British Columbia, Vancouver, Canada
| | - Erika Helgeson
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - Charles A Herzog
- Department of Medicine, Hennepin Healthcare/University of Minnesota, Minneapolis, Minnesota
| | - Meg Jardine
- Division of Nephrology, Department of Medicine, National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Vivekanand Jha
- Division of Nephrology, Department of Medicine, George Institute for Global Health, University of New South Wales, New Delhi, India
- Division of Nephrology, Department of Medicine, School of Public Health, Imperial College, London, United Kingdom
- Division of Nephrology, Department of Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Bertram L Kasiske
- Department of Medicine, Hennepin Healthcare/University of Minnesota, Minneapolis, Minnesota
| | - Roslyn B Mannon
- Division of Nephology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amy K Mottl
- Division of Nephrology, Department of Medicine, University of North Carolina Kidney Center, Chapel Hill, North Carolina
| | - Kristin Newby
- Division of Cardiology, Duke University School of Medicine, Durham, North Carolina
| | - Prabir Roy-Chaudhury
- Division of Nephrology, Department of Medicine, University of North Carolina Kidney Center, Chapel Hill, North Carolina
- Division of Nephrology, Department of Medicine, WG (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Deirdre Sawinski
- Nephrology and Transplantation, Weill Cornell Medical College, New York, New York
| | - Adnan Sharif
- Division of Nephrology, Department of Medicine, University Hospitals Birmingham, Birmingham, United Kingdom
| | - Vikas S Sridhar
- Division of Nephrology, Department of Medicine, Ajmera Transplant Centre, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Katherine R Tuttle
- Nephrology Division and Kidney Research Institute, University of Washington, Seattle, Washington
- Division of Nephrology, Department of Medicine, Providence Medical Research Center, Spokane, Washington
| | - David M Vock
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - Arthur Matas
- Division of Transplantation, University of Minnesota, Minneapolis, Minnesota
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