Living Donor Candidates’ Self-reported Health and Health Perceptions and Completion of Donor Evaluation: A Cohort Study

IF 3.2 Q1 UROLOGY & NEPHROLOGY
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引用次数: 0

Abstract

Rationale & Objective

Given the organ shortage in the United States, increasing living donation is vital to improving access to kidney transplantation, but many donor candidates do not complete the donor evaluation. Our objective was to understand potential living donors’ perceived health and its association with the likelihood of completing the donor evaluation process.

Study Design

Potential donors’ self-reported health was ascertained using the Patient Reported Outcomes Measurement Information System (PROMIS) global physical and mental health and the Davies and Ware Health Perceptions surveys.

Setting & Participants

Potential living donors who expressed interest in donation at a single medical center were recruited prospectively between 2017 and 2022.

Exposure

Donors' self-reported health and health perceptions.

Outcomes

Completion of the donor evaluation.

Analytical Approach

Adjusted linear and logistic regression models were used to examine the association between self-reported health and health perceptions with outcomes.

Results

A total of 1,347 individuals were included for study; 46% (N = 613) were < 40 years of age, 71% (n = 951) were female, 22% (n = 294) were of Hispanic ethnicity, and 16% (n = 215) completed the donor evaluation. The mean PROMIS global physical health (17.0 ± 1.9) and mental health (15.5 ± 2.7) raw scores were higher among donor candidates proceeding to completion of the donor evaluation when compared with those who withdrew early in the process (16.3 ± 2.2 for physical health and 14.9 ± 3.1 for mental health). Every z-score change in the PROMIS physical health score was associated with 1.48-fold higher odds of completing the donor evaluation (95% CI, 1.19-1.85). Fully adjusted models incorporating the PROMIS scores for predicting the completion of donor evaluations had a c-statistic of 0.70. Potential donors’ Davies and Wares health perceptions did not predict the likelihood of completing the donor evaluation in fully adjusted models.

Limitations

Data are derived from a single center and may not generalize to the donor evaluation process at other transplant centers.

Conclusions

Donor candidates’ self-reported physical health may serve as a predictor of the likelihood of completing the donor evaluation process and a potential avenue for future interventions.

Plain Language Summary

This study was designed to understand the health perceptions of living donor candidates. We found that donor candidates’ self-reported physical health strongly predicted their likelihood of completing the donor evaluation process. Further studies are needed to understand whether addressing donors’ self-perceptions of health may increase rates of completion of the donor evaluation.
活体捐献者候选人的自我健康报告和健康认知与捐献者评估的完成情况:队列研究
研究理由与目标鉴于美国器官短缺,增加活体捐献对改善肾移植的可及性至关重要,但许多捐献者候选人并未完成捐献者评估。我们的目的是了解潜在活体捐献者的感知健康状况及其与完成捐献者评估过程的可能性之间的关系。研究设计使用患者报告结果测量信息系统(PROMIS)全球身心健康和戴维斯与瓦尔健康感知调查来确定潜在捐献者的自我报告健康状况。暴露捐献者自我报告的健康状况和健康感知.结果完成捐献者评估.分析方法使用调整线性和逻辑回归模型来检验自我报告的健康状况和健康感知与结果之间的关联。结果共有 1347 人被纳入研究;46%(n = 613)的年龄为 40 岁,71%(n = 951)为女性,22%(n = 294)为西班牙裔,16%(n = 215)完成了捐献评估。与早期退出评估过程的捐献者相比,PROMIS 全球身体健康(17.0 ± 1.9)和心理健康(15.5 ± 2.7)平均原始分在完成捐献者评估的捐献者候选人中更高(身体健康为 16.3 ± 2.2,心理健康为 14.9 ± 3.1)。PROMIS身体健康评分每变化一个z分数,完成捐献者评估的几率就会增加1.48倍(95% CI,1.19-1.85)。包含 PROMIS 分数的预测捐赠者评估完成情况的完全调整模型的 c 统计量为 0.70。在完全调整模型中,潜在捐献者的戴维斯和瓦尔斯健康感知并不能预测完成捐献者评估的可能性。结论捐献者候选人自我报告的身体健康状况可能是完成捐献者评估过程可能性的预测因素,也是未来干预的潜在途径。我们发现,捐献者候选人自我报告的身体健康状况强烈预示着他们完成捐献者评估过程的可能性。我们需要进一步研究,以了解解决捐献者对健康的自我认知问题是否能提高捐献者评估的完成率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Kidney Medicine
Kidney Medicine Medicine-Internal Medicine
CiteScore
4.80
自引率
5.10%
发文量
176
审稿时长
12 weeks
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