title: African American kidney transplant patients' perspectives on challenges in the living donation process.
abstract: BACKGROUND
  The increasing shortage of deceased donor kidneys suitable for African Americans highlights the critical need to increase living donations among African Americans. Little research has addressed African American transplant recipients' perspectives on challenges and barriers related to the living donation process.
  
  
  OBJECTIVE
  To understand the perspectives of African American recipients of deceased and living donor kidney transplants on challenges, barriers, and educational needs related to pursuing such transplants.
  
  
  METHODS
  A mixed-method design involved 27 African American kidney recipients (13 male) in 4 focus groups (2 per recipient type: 16 African American deceased donor and 11 living donor recipients) and questionnaires. Focus group transcripts were evaluated with NVivo 10.0 (QSR, International) by using inductive and deductive qualitative methods along with crystallization to develop themes of underlying barriers to the living donor kidney transplant process and were compared with the questionnaires.
  
  
  RESULTS
  Four main themes were identified from groups: concerns, knowledge and learning, expectations of support, and communication. Many concerns for the donor were identified (eg, process too difficult, financial burden, effect on relationships). A general lack of knowledge about the donor process and lack of behavioral skills on how to approach others was noted. The latter was especially evident among deceased donor recipients. Findings from the questionnaires on myths and perceptions supported the lack of knowledge in a variety of domains, including donors' surgical outcomes risks, costs of surgery, and impact on future health. Participants thought that an educational program led by an African American recipient of a living donor kidney transplant, including practice in approaching others, would increase the likelihood of transplant-eligible patients pursuing living donor kidney transplant.
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: John C
authors.initials: JC
authors.lastname: Sieverdes
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: Lynne S
authors.initials: LS
authors.lastname: Nemeth
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: Gayenell S
authors.initials: GS
authors.lastname: Magwood
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: Prabhakar K
authors.initials: PK
authors.lastname: Baliga
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Chavin
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: Ken J
authors.initials: KJ
authors.lastname: Ruggiero
authors.affiliation: Medical University of South Carolina, Charleston (JCS, LSN, GSM, PKB, KDC, KJR, FAT), Ralph H. Johnson VA Medical Center, Charleston, South Carolina (KJR).
authors.forename: Frank A
authors.initials: FA
authors.lastname: Treiber
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000523:psychology*; D019520:Living Donors / Q000193:education / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement; D014481:United States / Q000453:epidemiology