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Author Topic: Seeking Living Donors' Opinions about Donor Education and Informed Consent  (Read 5333 times)

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Offline egordon

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Hi all,

I am a social scientist preparing to write a grant to the Patient-Centered Outcomes Research Institute (PCORI) on helping living donors prepare for living donation. PCORI grants are designed to be patient-centered.  I am asking living donors (both potential donors and those who already donated) on this listserv for information to help me prepare this grant.  I am not doing research.

Specifically, informed consent is a legal and ethical requirement for living donors. Studies show that many living donors are not satisfied with the education and informed consent process, do not feel that clinicians disclose enough information, or that donors do not fully comprehend that information. My goal is to improve the education and informed consent process to make sure that donors are optimally informed and prepared to donate.  I am writing to ask your help to learn what is important to you.  Your feedback will be very much appreciated!  I have 3 sets of questions:

Set 1:
1.   What surprised you about being a living donor?  What weren’t you aware of?

2.   How would you like to change the education and informed consent process?

3.   What do you wish you were told that you learned after donating?

4.   How would you like your health care professionals to communicate information to you?

5.   How would you change the delivery of information to potential donors?
a.   There are lots of ways to communicate information to potential donors e.g., through face to face discussions, pamphlets, booklets, videos, websites, web-based games and quizzes, smart phone mobile apps, etc. Which way would you think would be helpful to you or preferred by potential donors?

6.   How helpful would it be to have a web-based learning tool that uses videos and games to educate potential donors?   
a.   Would you prefer web-based learning with or without quizzes that test whether donors fully understand what they are getting into?

7.   Living donors who are cleared to donate still have health risks. Would you be interested in having a method to calculate your specific risks compared to other donors e.g., your risk of developing hypertension after donating (“donor risk calculator”)?

8.   All transplant programs have an education process for donors. I’m interested in your general attitude toward obtaining health information.  In looking back at your experience, would you have liked to have learned a minimal amount, a moderate amount, or every possible detail about what could happen to living donors?

9.   Do you have any further comments about informed consent or about your experience you would like to share?



Set 2:
What are the 3 most important living donor outcomes of being educated about living donation that should be measured?  In other words, what living donor factors might be affected in the short-term or long-term by being educated and/or prepared about living donation and should be studied?  Please check the three most important outcomes that you think should be considered when educating potential living donors.”  Please write in others that you think should be added.
___ Comprehension of living donor risks, benefits, alternatives to donating
___ Preparedness to care for one self after donation
___ Psychosocial health e.g., anxiety, quality of life
___ Satisfaction with donation experience
___ Length of hospital stay
___ Pain management (what it’s like to feel afterward)
___ Expected outcome of recipient
___ Ability to return to normal activities
___ Finances of donation and complications
___ Complications
___ Lifestyle changes
___ Other (please specify): ___________________________________________

Set 3:
1.   What kinds of subgroups of living donors would be most important to study? Please check the top 3 groups that you think are important.
___ Directed donors
___ Nondirected donors
___ Non-English speaking donors
___ Liver donors
___ Kidney donors
___ Donors with risk factors: e.g., ethnic/racial minority donors, borderline hypertensive,
overweight donors
___ Adult to adult
___ Adult to child
___ Extended & Standard
___ Family relationships vs. distant relationships & friends
___ Paired donation
___ Donors whose recipient had psychological and physical complications within the first
year post-transplant
___ Donors without recipient complications
___ Donors who are satisfied with their experience, e.g., they did not experience
complications
___ Donors who are not satisfied with their experience e.g., they
experienced complications
___ Recipients of living donor kidneys or liver lobes
___ Older donors (over age 50 to 60)
___ Other (please specify): _________________________________

I look forward to hearing your thoughts. Feel free to email me directly at e-gordon@northwestern.edu
Thank you!
Best wishes,
Elisa

Online Clark

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Offline egordon

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Hi all,

No one has replied online, although this post has received 144 views!   I've received only ~ 10 responses to my email account.

I welcome hearing more perspectives.  In particular, I would like to hear from living donors who did not have a good experience.

I've heard from some donors that there is a social bias against sharing bad experiences of donating, because of the importance of supporting the cause overall.  However, each person's experience is unique and worthwhile sharing. 

Everything shared is kept confidential.

Thank you again!

Best wishes,
Elisa

Offline sherri

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Elisa,

Thank you for taking the time to seek living donors' opinions and experiences. I did participate in this project in addition to other research that you have done on behalf of living donors.  I recommend participating in this survey to other living donors. If we do not take initiative and advocate for living donors then it will be much harder to make improvements where needed. I encourage others to participate and will pass along this message to my donor list.

Thank you for all the work you do on behalf of living donors.


Sherri

Sherri
Living Kidney Donor 11/12/07

Offline egordon

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Sherri,

Thanks so much for your continued support! I really appreciate it.

I have another question for the group:
Do you think potential donors often not know the 'right' questions to ask?  If so, would the following be a good solution:
Would it help potential living donors if we created a "question prompt list" -  this is a list of questions that is given to potential donors to review and bring with them to their clinic visits.  The purpose of this list to help potential donors to remember what to ask their clinicians/providers, to make sure that they get important information that they may otherwise forget to ask, or not know to ask, or were too afraid to ask. 

If you all think this question prompt list would help, I will be happy to make it!

Thanks again,
Elisa

Offline StressedJess

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Re: Seeking Living Donors' Opinions about Donor Education and Informed Consent
« Reply #5 on: September 08, 2013, 02:08:54 PM »
Hi Elisa,
I am being evaluated to be a living liver donor for my husband. I'm trying to pull together a list of questions to ask the doctors and surgeons when I go to my eval meeting, but information is hard to find! Would you mind sharing any "question prompts" you may have? I don't know if your question prompts are more geared toward kidney donation, but any input would help at this point!
Thanks so much,
Jess

Offline egordon

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Re: Seeking Living Donors' Opinions about Donor Education and Informed Consent
« Reply #6 on: September 08, 2013, 03:02:54 PM »
HI Jess,
Good luck with everything!  I have not yet made made the list of questions (I'm proposing to do so in a grant application). It seems like it could really come in handy. 
I believe Cristy Wright has some questions that may help - you may want to check out her blog at:
http://www.livingdonor101.com/
Go to the tab called 'The Decision' and then the bottom drop down list has 'Questions to ask'.
I hope this helps!
Best wishes,
Elisa

Offline StressedJess

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Re: Seeking Living Donors' Opinions about Donor Education and Informed Consent
« Reply #7 on: September 08, 2013, 06:19:27 PM »
Thank you. I'll look into that.
I do think something like that would be handy! This is such a big decision with seemingly minimal information available. Best of luck with your grant application!

 

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