title: Sociodemographic factors and patient perceptions are associated with attitudes to kidney transplantation among haemodialysis patients.
abstract: 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.
authors.affiliation: Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Eszter Panna
authors.initials: EP
authors.lastname: Vamos
authors.forename: Gabor
authors.initials: G
authors.lastname: Csepanyi
authors.forename: Monika
authors.initials: M
authors.lastname: Zambo
authors.forename: Miklos Zsolt
authors.initials: MZ
authors.lastname: Molnar
authors.forename: Janos
authors.initials: J
authors.lastname: Rethelyi
authors.forename: Agnes
authors.initials: A
authors.lastname: Kovacs
authors.forename: Adrienn
authors.initials: A
authors.lastname: Marton
authors.forename: Zsofia
authors.initials: Z
authors.lastname: Nemeth
authors.forename: Marta
authors.initials: M
authors.lastname: Novak
authors.forename: Istvan
authors.initials: I
authors.lastname: Mucsi
mesh_terms: 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