The Impact of Dialysis Facility Performance on Dialysis Facility Providers' Preparedness to Educate Dialysis Patients about Kidney Transplantation Options Público

Isenhour, Cheryl Joy (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/fx719m569?locale=es
Published

Abstract

Objective: Dialysis facility providers play a crucial role in facilitating access to kidney transplantation through patient referral to a kidney transplant center. Few studies have sought to assess the opinions of dialysis facility providers regarding preparedness to educate patients about transplantation. We sought to determine whether dialysis facility providers from Georgia facilities with historically higher kidney transplant percent referral performance were more or less likely to demonstrate a positive change in opinion regarding their own preparedness to educate dialysis patients after attending Explore Transplant (ET) Dialysis Facility Provider Training, as compared to staff from Georgia dialysis facilities with historically lower referral performance.

Methods: We evaluated survey data collected before and after four ET training sessions held in Georgia during 2014. These data were linked to 2008-2011 Dialysis Facility Report (DFR) data, and facility referral data (2013 data). We used multivariable logistic regression to evaluate the relationship between positive change in opinion following exposure to ET provider training (outcome) and historical dialysis facility kidney transplant referral performance (exposure).

Results: The four ET training sessions attracted 101 dialysis facility staff attendees representing 85 unique dialysis facilities. In a crude logistic regression model, staff members representing facilities with higher historical percent transplant referral were more likely to demonstrate a positive change in opinion regarding their own confidence as a transplant educator following ET training, as compared to staff representing facilities with lower historical percent transplant referral [OR = 2.61 (95% CI: 1.10-6.45)]. This relationship was also evident in a multivariable logistic regression model adjusted for number of patients treated within the facility and for-profit status, with high vs. low performing facilities nearly three times more likely to feel confident in their transplant education abilities after attending the training [OR=2.99 (95% CI: 1.11-8.04)] [Table 3].

Conclusions:Staff members representing facilities with higher historical transplant referral performance were more likely to feel confident about their transplant education abilities after ET training. Additional research should focus on why staff from facilities with historically lower referral performance are not as confident in their abilities to educate, despite receiving kidney transplant educator training.

Table of Contents

Table of Contents

Chapter I: Background

The Significance and Burden of Chronic and End Stage Kidney Disease

Demographic Profile of ESRD Network 6

Chronic and End Stage Renal Disease Risk Factors

Disparities in Renal Transplantation

The Impact of Dialysis Facility Level Factors on Transplantation Rates

The Importance of Education about Kidney Transplant Options

The RaDIANT Community Study and Explore Transplant

The Importance of Evaluating Dialysis Facility Providers' Preparedness to Educate

Chapter II: Manuscript

Introduction

Methods

Explore Transplant Dialysis Facility Provider Training

Data Sources

Data Cleaning

Study Population

Study Variables

Analysis

Results

Dialysis Facility Staff Characteristics

Dialysis Facility Characteristics

Association between Historical Referral and Preparedness to Educate

Discussion

Study Limitations

Conclusions

References

Tables

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