Topics, Delivery Modes, and Social-Epistemological Dimensions of Web-Based Information for Patients Undergoing Renal Transplant and Living Donors During the COVID-19 Pandemic: Content Analysis

Interactive Health Technology Tool for Kidney Living Donor Assessment to Standardize the Informed Consent Process: Usability and Qualitative Content Analysis

BACKGROUND

Kidney living donation carries risks, yet standardized information provision regarding nephrectomy risks and psychological impacts for candidates remains lacking.

OBJECTIVE

This study assesses the benefit of interactive health technology in improving the informed consent process for kidney living donation.

METHODS

The Kidney Hub institutional open portal offers comprehensive information on kidney disease and donation. Individuals willing to start the kidney living donation process at Helsinki University Hospital (January 2019-January 2022) were invited to use the patient-tailored digital care path (Living Donor Digital Care Path) included in the Kidney Hub. This platform provides detailed donation process information and facilitates communication between health care professionals and patients. eHealth literacy was evaluated via the eHealth Literacy Scale (eHEALS), usability with the System Usability Scale (SUS), and system utility through Likert-scale surveys with scores of 1-5. Qualitative content analysis addressed an open-ended question.

RESULTS

The Kidney Hub portal received over 8000 monthly visits, including to its sections on donation benefits (n=1629 views) and impact on donors' lives (n=4850 views). Of 127 living kidney donation candidates, 7 did not use Living Donor Digital Care Path. Users' ages ranged from 20 to 79 years, and they exchanged over 3500 messages. A total of 74 living donor candidates participated in the survey. Female candidates more commonly searched the internet about kidney donation (n=79 female candidates vs n=48 male candidates; P=.04). The mean eHEALS score correlated with internet use for health decisions (r=0.45; P<.001) and its importance (r=0.40; P=.01). Participants found that the Living Donor Digital Care Path was technically satisfactory (mean SUS score 4.4, SD 0.54) and useful but not pivotal in donation decision-making. Concerns focused on postsurgery coping for donors and recipients.

CONCLUSIONS

Telemedicine effectively educates living kidney donor candidates on the donation process. The Living Donor Digital Care Path serves as a valuable eHealth tool, aiding clinicians in standardizing steps toward informed consent.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04791670; https://clinicaltrials.gov/study/NCT04791670.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2021-051166.

Telemedicine for Kidney Transplant Recipients: Current State, Advantages, and Barriers

Telemedicine is defined as the use of electronic information and communication technologies to provide and support healthcare at a distance. In kidney transplantation, telemedicine is limited but is expected to grow markedly in the coming y. Current experience shows that it is possible to provide transplant care at a distance, with benefits for patients like reduced travel time and costs, better adherence to medication and appointment visits, more self-sufficiency, and more reliable blood pressure values. However, multiple barriers in different areas need to be overcome for successful implementation, such as recipients' preferences, willingness, skills, and digital literacy. Moreover, in many countries, limited digital infrastructure, legislation, local policy, costs, and reimbursement issues could be barriers to the implementation of telemedicine. Finally, telemedicine changes the way transplant professionals provide care, and this transition needs time, training, willingness, and acceptance. This review discusses the current state and benefits of telemedicine in kidney transplantation, with the aforementioned barriers, and provides an overview of future directions on telemedicine in kidney transplantation.

Didactical characteristics of Dutch websites about kidney transplantation targeted for kidney patients and living donors: An exploratory study

Objective

The aim was to explore the origin, content topics, teaching modes (instruction, interaction, and assessment), and corresponding social-epistemological dimensions (choices in knowledge transfer vs. knowledge building, and individual vs. group learning) of web-based information on kidney transplantation targeted for patients and living donors.

Methods

Dutch websites on kidney transplantation were retrieved using the search engine Google.nl. From 24 websites, 250 webpages were examined on origin, content topics, teaching modes, and corresponding social-epistemological dimensions.

Results

The majority of the websites had a professional organization as origin (20/24). The number and distribution of content topics varied among the websites. Of the 16 different teaching modes found, 11 were instructional, 4 were interactional, and 1 assessment mode was found. The websites offered almost exclusively teaching modes on individual and passive learning, whereas group learning and interactive knowledge building was hardly encountered.

Conclusion

The diversity in teaching modes and social-epistemological dimensions of Dutch websites on kidney transplantation targeted for patients and living donors is limited. The websites only provided a partial view on kidney transplantation; information regarding contact with others, e.g. support, was limited. A more balanced availability of teaching approaches and content topics is desirable to fit with the didactical goals to make well-considered health decisions.

Effect of neuro-linguistic programming on COVID-19 fear in kidney transplant patients: A randomized controlled study

This study was conducted experimentally to evaluate the effect of neuro-linguistic programming (NLP) on fear of COVID-19 in kidney transplant patients. The study was carried out between June 2021 and October 2021. The Personal Information Form and COVID-19 Fear Scale (FCV-19S) were used to collect data. The obtained data obtained were evaluated using the SPSS 25 software. NLP was found to reduce the fear of COVID-19 in kidney transplant patients. Clinical nurses can use NLP techniques to support patients with fear in similar patient groups. Patients can be provided with access to training programs where they can learn NLP techniques. CLINICALTRIALS.GOV: NCT05115435.

Quality of Life of Hemodialysis Patients during COVID-19 Pandemic in Gatoel Hospital, Mojokerto City

AIM: The purpose of this study was to analyze the quality of life of hemodialysis patients during the COVID-19 pandemic. METHODS: This study used a descriptive design. The sample in this study was hemodialysis patients at the Gatoel Hospital, Mojokerto City, as many as 122 respondents who were determined using simple random sampling technique. The sample criteria in this study were hemodialysis patients at Gatoel Hospital, Mojokerto City, undergoing hemodialysis therapy <2 years, and willing to participate in research activities. The research instrument used was adopted from the WHOQOL-BREF questionnaire. RESULTS: From the results of the study, it was found that more than half of the respondents had poor physical health dimensions as many as 62 respondents (50.8%), more than half of respondents had poor mental health dimensions as many as 68 respondents (55.7%), more than half of respondents had social health dimensions. Bad as many as 62 respondents (50.8%) and most respondents have poor functional health dimensions as many as 74 respondents (60.7%). CONCLUSION: It was found that more than half of the respondents in this study had poor quality of life. More than half of the respondents had physical health dimensions in the poor category, more than half of the respondents had mental health dimensions in the bad category, more than half of the respondents had social health dimensions in the bad category and most of the respondents had functional health dimensions in the bad.

Digital Support for Renal Patients Before and During the COVID-19 Pandemic: Examining the Efforts of Singapore Social Service Agencies in Facebook

During the coronavirus disease 2019 (COVID-19) pandemic, social service agencies (SSAs) play a crucial role in supporting renal patients, who are particularly vulnerable to infections. Social media platforms such as Facebook, serves as an effective medium for these SSAs to disseminate information. Content analysis of the SSAs’ Facebook posts can provide insights on whether Facebook has been adequately utilized during the COVID-19 pandemic and enable SSAs to improve their social media use in future pandemics. This study aimed to compare renal-related SSAs’ Facebook post content before and during the COVID-19 pandemic. Facebook posts of three SSAs National Kidney Foundation (NKF), Kidney Dialysis Foundation (KDF), and Muslim Kidney Action Association (MKAC), posted during the pre-COVID-19 period (January 23, 2019 to June 2, 2019) and the peri-COVID-19 period (January 23, 2020 to June 1, 2020) were extracted. A classification scheme was developed by two coders with themes derived inductively and deductively. Each Facebook post was assigned with a theme. Quantitative analyses indicate that the number of Facebook posts increased from 115 in the pre-COVID-19 period to 293 in the peri-COVID-19 period. During peri-COVID-19, posts regarding lifestyle changes, donations and infectious disease surfaced. While the proportion of posts about encouraging kindness increased from one to 77 posts, the proportion of posts about community-based events and psychosocial support decreased from 44 to 15 posts and 17 to 10 posts respectively during the two periods. Facebook was found to be well-utilized by two of the three renal SSAs in engaging their beneficiaries during the pandemic. During future pandemics, renal SSAs should place emphasis on posts related to psychosocial support and encouraging kindness. Further studies are required to ascertain the impact of COVID-19 from the perspective of renal patients and also to validate the classification scheme which was developed in this study. The study’s methodology and classification scheme can be used to guide future studies for evaluating the social media outreach performance of renal health support groups.

Evolution of Bystander Intention to Perform Resuscitation Since Last Training: Web-Based Survey

BACKGROUND

Victims of out-of-hospital cardiac arrest (OHCA) have higher survival rates and more favorable neurological outcomes when basic life support (BLS) maneuvers are initiated quickly after collapse. Although more than half of OHCAs are witnessed, BLS is infrequently provided, thereby worsening the survival and neurological prognoses of OHCA victims. According to the theory of planned behavior, the probability of executing an action is strongly linked to the intention of performing it. This intention is determined by three distinct dimensions: attitude, subjective normative beliefs, and control beliefs. We hypothesized that there could be a decrease in one or more of these dimensions even shortly after the last BLS training session.

OBJECTIVE

The aim of this study was to measure the variation of the three dimensions of the intention to perform resuscitation according to the time elapsed since the last first-aid course.

METHODS

Between January and April 2019, the two largest companies delivering first-aid courses in the region of Geneva, Switzerland sent invitation emails on our behalf to people who had followed a first-aid course between January 2014 and December 2018. Participants were asked to answer a set of 17 psychometric questions based on a 4-point Likert scale ("I don't agree," "I partially agree," "I agree," and "I totally agree") designed to assess the three dimensions of the intention to perform resuscitation. The primary outcome was the difference in each of these dimensions between participants who had followed a first-aid course less than 6 months before taking the questionnaire and those who took the questionnaire more than 6 months and up to 5 years after following such a course. Secondary outcomes were the change in each dimension using cutoffs at 1 year and 2 years, and the change regarding each individual question using cutoffs at 6 months, 1 year, and 2 years. Univariate and multivariable linear regression were used for analyses.

RESULTS

A total of 204 surveys (76%) were analyzed. After adjustment, control beliefs was the only dimension that was significantly lower in participants who took the questionnaire more than 6 months after their last BLS course (P<.001). Resisting diffusion of responsibility, a key element of subjective normative beliefs, was also less likely in this group (P=.001). By contrast, members of this group were less afraid of disease transmission (P=.03). However, fear of legal action was higher in this group (P=.02).

CONCLUSIONS

Control beliefs already show a significant decrease 6 months after the last first-aid course. Short interventions should be designed to restore this dimension to its immediate postcourse state. This could enhance the provision of BLS maneuvers in cases of OHCA.

Dietary Assessment and Self-Management Using Information Technology in Order to Improve Outcomes in Kidney Transplant Recipients

Big data and artificial intelligence (AI) will transform the way research in nephrology is carried out and consequently improve the performance of clinical practice in nephrology and transplantation. Managing long-term health outcomes in kidney transplant recipients (KTR) includes the improvement of modifiable factors, such as diet. Self-management using information technology (IT) aims to facilitate lifestyle changes, manage symptoms and treatment in the course of chronic kidney disease (CKD) or any chronic condition. The advantages of health mobile applications further include the capacity of data compilation and yielding responses to numerous research questions in nephrology and transplantation. However, studies investigating the employment of such applications in KTR and its impact in kidney transplant outcomes are still lacking. The specific advantages of dietary assessment and self-management using IT in order to improve outcomes in KTR are presently discussed. This Special Issue features a great set of articles regarding IT approaches to improve kidney allograft survival and posttransplant outcomes in all areas.