Special ArticleImportant Outcomes for Kidney Transplant Recipients: A Nominal Group and Qualitative Study
Section snippets
Study Design and Participants
A combined focus/nominal group technique18 was used to generate a list of outcomes that kidney transplant recipients identify with taking immunosuppressant medication and to rank the relative importance of these outcomes.
Participants were recruited from 3 large transplant units located in Sydney and Melbourne. They were purposively selected to achieve a mix of sex, age, and time since transplant. Participants were eligible if they were English speaking, older than 18 years, able to give
Participant Characteristics
Of 62 kidney transplant recipients who accepted an invitation to attend a focus/nominal group, 57 (92%) participated in 1 of 8 groups. Reasons for nonattendance were illness (3), unable to arrange transport on that day (1), and not stated (1). Ages ranged from 20-70 (mean, 47.8) years, and 33 (58%) were men (Table 1). Fifty-five (95%) had received a kidney transplant; 2, a combined kidney-pancreas transplant; and 1, a combined kidney-liver transplant. Four (7%) had received more than one
Discussion
Our study shows that transplant recipients are willing to trade off not only unpleasant side effects of stronger immunosuppression, such as weight gain and hair loss, but also serious events, such as cancer, in order to maintain stable and satisfactory transplant function and thereby avoid a return to dialysis therapy. Transplant rejection and decreasing kidney function were viewed as inevitably leading to transplant loss, the fear of which was so dominant that only a small number of
Acknowledgements
We thank the kidney transplant recipients from Westmead, Royal Prince Alfred, and Royal Melbourne hospitals who participated in this study and who generously gave their time and shared their opinions and personal experiences.
Support: Dr Howell is supported by National Health and Medical Research Council (NHMRC) Capacity Building Grant ID 571372. Dr Tong is supported by a postdoctoral research fellowship (funded under the NHMRC Capacity Building Grant in Population Health, ID 457281). The
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Originally published online May 11, 2012.