title: Home-based family intervention increases knowledge, communication and living donation rates: a randomized controlled trial.
abstract: Our aim was to develop and test an educational program to support well-informed decision making among patients and their social network regarding living donor kidney transplantation (LDKT). One hundred sixty-three patients who were unable to find a living donor were randomized to standard care or standard care plus home-based education. In the education condition, patients and members of their social network participated in home-based educational meetings and discussed renal replacement therapy options. Patients and invitees completed pre-post self-report questionnaires measuring knowledge, risk perception, communication, self-efficacy and subjective norm. LDKT activities were observed for 6 months postintervention. Patients in the experimental group showed significantly more improvements in knowledge (p < 0.001) and communication (p = 0.012) compared with the control group. The invitees showed pre-post increases in knowledge (p < 0.001), attitude toward discussing renal replacement therapies (p = 0.020), attitude toward donating a kidney (p = 0.023) and willingness to donate a kidney (p = 0.039) and a decrease in risk perception (p = 0.003). Finally, there were significantly more inquiries (29/39 vs. 13/41, p < 0.001), evaluations (25/39 vs. 7/41, p < 0.001) and actual LDKTs (17/39 vs. 4/41, p = 0.003) in the experimental group compared with the control group. Home-based family education supports well-informed decision making and promotes access to LDKT.
authors.affiliation: Department of Psychiatry, Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: S Y
authors.initials: SY
authors.lastname: Ismail
authors.forename: A E
authors.initials: AE
authors.lastname: Luchtenburg
authors.forename: R
authors.initials: R
authors.lastname: Timman
authors.forename: W C
authors.initials: WC
authors.lastname: Zuidema
authors.forename: C
authors.initials: C
authors.lastname: Boonstra
authors.forename: W
authors.initials: W
authors.lastname: Weimar
authors.forename: J J V
authors.initials: JJ
authors.lastname: Busschbach
authors.forename: E K
authors.initials: EK
authors.lastname: Massey
mesh_terms: D000368:Aged; D003142:Communication; D003466:Cultural Characteristics; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000523:psychology* / Q000601:surgery; D012306:Risk; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Counseling; ethnicity; family communication; living kidney donation; patient support program