Sociodemographic factors and patient perceptions are associated with attitudes to kidney transplantation among haemodialysis patients.
BACKGROUND
Treatment decisions made by patients with chronic kidney disease are crucial in the renal transplantation process. These decisions are influenced, amongst other factors, by attitudes towards different treatment options, which are modulated by knowledge and perceptions about the disease and its treatment and many other subjective factors. Here we study the attitude of dialysis patients to renal transplantation and the association of sociodemographic characteristics, patient perceptions and experiences with this attitude.


METHODS
In a cross-sectional study, all patients from eight dialysis units in Budapest, Hungary, who were on haemodialysis for at least 3 months were approached to complete a self-administered questionnaire. Data collected from 459 patients younger than 70 years were analysed in this manuscript.


RESULTS
Mean age of the study population was 53 +/- 12 years, 54% were male and the prevalence of diabetes was 22%. Patients with positive attitude to renal transplantation were younger (51 +/- 11 versus 58 +/- 11 years), better educated, more likely to be employed (11% versus 4%) and had prior transplantation (15% versus 7%)(P < 0.05 for all). In a multivariate model, negative patient perceptions about transplantation, negative expectations about health outcomes after transplantation and the presence of fears about the transplant surgery were associated, in addition to increasing age, with unwillingness to consider transplantation.


CONCLUSIONS
Negative attitudes to renal transplantation are associated with potentially modifiable factors. Based on this we suggest that it would be necessary to develop standardized, comprehensible patient information systems and personalized decision support to facilitate modality selection and to enable patients to make fully informed treatment decisions.
Vamos
Eszter Panna
EP
Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
Csepanyi
Gabor
G
Zambo
Monika
M
Molnar
Miklos Zsolt
MZ
Rethelyi
Janos
J
Kovacs
Agnes
A
Marton
Adrienn
A
Nemeth
Zsofia
Z
Novak
Marta
M
Mucsi
Istvan
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006814:Hungary; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult