Objective: Despite living donor kidney transplantation (LDKT) being the optimal treatment option for patients with end-stage renal disease, we observed a significant inequality in the number of LDKT performed between patients of Dutch versus non-Dutch descent. We conducted a focus group study to explore modifiable hurdles to LDKT. Methods: Focus group discussions and in-depth interviews were conducted among 50 end-stage renal patients. Analyses were conducted according to 'grounded theory' using Atlas.ti. Results: We found nearly all patients to be in favor of LDKT (96%). However, multiple factors played a role in considering LDKT. Four potentially modifiable hurdles were derived: (1) inadequate patient education, (2) impeding cognitions and emotions, (3) restrictive social influences, and (4) suboptimal communication. With regard to solutions, we found that our patients were open to home-based group education on renal replacement therapy options (88% in favor). Conclusion: The study highlights the need for sensitivity and awareness of the influence of cultural factors on decision-making when discussing living donation with culturally diverse populations. Practice implications: Since the majority of our patients were open to a tailored group education in their own homes, we see this as an opportunity to address factors that influence equality in access to LDKT.

Attitudes, Communication, Ethnicity, Kidney transplantation, Patient education
dx.doi.org/10.1016/j.pec.2012.08.004, hdl.handle.net/1765/65144
Patient Education and Counseling
Department of Internal Medicine

Ismail, S.Y, Claassens, L, Luchtenburg, A.E, Roodnat, J.I, Zuidema, W.C, Weimar, W, … Massey, E.K. (2013). Living donor kidney transplantation among ethnic minorities in the Netherlands: A model for breaking the hurdles. Patient Education and Counseling, 90(1), 118–124. doi:10.1016/j.pec.2012.08.004