title: A qualitative assessment of personal and social responsibility for kidney disease: the Increasing Kidney Disease Awareness Network Transplant Project.
abstract: BACKGROUND
  Limited qualitative research has explored opinions of kidney disease health care providers regarding racial and ethnic disparities in access to and receipt of kidney transplantation.
  
  
  METHODS
  Key informant interviews were conducted among transplant nephrologists, nephrologists, transplant social workers, and transplant coordinators to determine barriers to transplantation among African Americans compared to whites with end-stage renal disease (ESRD).
  
  
  METHODS
  Thirty-eight interviews were audio recorded and transcribed to hardcopy for content analysis. Grounded theory was used to determine dominant themes within the interviews. Reliability and validity were ensured by several coinvestigators independently sorting verbatim responses used for generating themes and subsequent explanations.
  
  
  RESULTS
  Several major categories arose from analysis of the transcripts. Under the category of personal and social responsibility for kidney transplantation, interviews revealed 4 major themes: negative personal behaviors, acquisition of and lack of self-treatment of comorbid conditions, lack of individual responsibility, and the need for more social responsibility. Many providers perceived patients as being largely responsible for the development of ESRD, while some providers expressed the idea that more social responsibility was needed to improve poor health status and disparities in kidney transplantation rates.
  
  
  CONCLUSIONS
  Kidney disease health providers seemed torn between notions of patients' accountability and social responsibility for racial disparities in chronic kidney disease and ESRD. Further research is needed to clarify which aspects contribute most to disparities in access to transplantation.
authors.affiliation: Health Services Department, School of Public Health University of Washington, Seattle, USA.
authors.forename: Clarence
authors.initials: C
authors.lastname: Spigner
authors.forename: Courtney Rees
authors.initials: CR
authors.lastname: Lyles
authors.forename: Georgia
authors.initials: G
authors.lastname: Galvin
authors.forename: Janice
authors.initials: J
authors.lastname: Sabin
authors.forename: Connie
authors.initials: C
authors.lastname: Davis
authors.forename: Andre
authors.initials: A
authors.lastname: Dick
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
mesh_terms: D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D016030:Kidney Transplantation; D008019:Life Style; D008297:Male; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012941:Social Responsibility