Understanding the pros and cons of organ donation decision-making: Decisional balance and expressing donation intentions among African Americans

Increasing public commitment to organ donation is critical to improving donor kidney availability for end-stage renal disease patients desiring transplant. This study surveyed ( N = 1339) African Americans, measuring perceived pros relative to cons of organ donation, to evaluate an existing Transtheoretical Model decisional balance scale and associations between decisional balance and expressing donation intentions. Findings supported the existing scale structure. More positive decisional balance ratios were associated with 1.76 times the odds of expressing intentions (95% confidence interval = 1.52–2.04). Pros were more strongly linked to donation intentions than cons. Greater understanding of organ donation decision-making is valuable for informing interventions that encourage donation.

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Cognitive mapping as an approach to facilitate organ donation among African Americans

Science Progress ◽

10.1177/00368504211029442 ◽

2021 ◽

Vol 104 (3) ◽

pp. 003685042110294

Author(s):

Jayme E Locke ◽

Rhiannon D Reed ◽

Richard M Shewchuk ◽

Katherine L Stegner ◽

Haiyan Qu

Keyword(s):

Decision Making ◽

African Americans ◽

Organ Donation ◽

Cognitive Mapping ◽

The United States ◽

Two Dimensions ◽

Nominal Group ◽

Solid Organ ◽

Related Information ◽

Empirical Framework

Making up 13.4% of the United States population, African Americans (AAs) account for 28.7% of candidates who are currently waiting for an organ donation. AAs are disproportionately affected by end-organ disease, particularly kidney disease, therefore, the need for transplantation among this population is high, and the high need is also observed for other solid organ transplantation. To this end, we worked with the AA community to derive an empirical framework of organ donation strategies that may facilitate AA decision-making. We used a cognitive mapping approach involving two distinct phases of primary data collection and a sequence of data analytic procedures to elicit and systematically organize strategies for facilitating organ donation. AA adults ( n = 89) sorted 27 strategies identified from nominal group technique meetings in phase 1 based on their perceived similarities. Sorting data were aggregated and analyzed using Multidimensional scaling and hierarchical cluster analyses. Among 89 AA participants, 68.2% were female, 65.5% obtained > high school education, 69.5% reported annual household income ≤ $50,000. The average age was 47.4 years (SD = 14.5). Derived empirical framework consisted of five distinct clusters: fundamental knowledge, psychosocial support, community awareness, community engagement, and system accountability; and two dimensions: Approach, Donor-related Information. The derived empirical framework reflects an organization scheme that may facilitate AA decision-making about organ donation and suggests that targeted dissemination of donor-related information at both the individual-donor and community levels may be critical for increasing donation rates among AAs.

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Predicting end-stage renal disease: Bayesian perspective of information transfer in the clinical decision-making process at the individual level

Kidney International ◽

10.1046/j.1523-1755.2003.00923.x ◽

2003 ◽

Vol 63 (5) ◽

pp. 1924-1933 ◽

Cited By ~ 8

Author(s):

Borislav D. Dimitrov ◽

Annalisa Perna ◽

Piero Ruggenenti ◽

Giuseppe Remuzzi

Keyword(s):

Decision Making ◽

End Stage Renal Disease ◽

Information Transfer ◽

Clinical Decision Making ◽

Clinical Decision ◽

Decision Making Process ◽

Individual Level ◽

The Individual ◽

Stage Renal Disease ◽

End Stage

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Marriage and End-Stage Renal Disease: Implications for African Americans

Journal of Family Issues ◽

10.1177/0192513x10365831 ◽

2010 ◽

Vol 31 (9) ◽

pp. 1230-1249

Author(s):

Emily F. Shortridge ◽

Cara V. James

Keyword(s):

African Americans ◽

Renal Disease ◽

End Stage Renal Disease ◽

Well Being ◽

Lifestyle Changes ◽

Treatment Modalities ◽

Dialysis Facilities ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

African Americans are disproportionately represented among patients with end-stage renal disease (ESRD). ESRD is managed with a strict routine that might include regular dialysis as well as dietary, fluid intake, and other lifestyle changes. In a disease such as this, with such disruptive treatment modalities, marriage, specifically, and its ties to well-being have the potential to significantly affect adherence to medical treatment and lifestyle recommendations as well as downstream health outcomes such as disease progression and mortality. The authors used data from the Dialysis Morbidity and Mortality Study, Wave 2, of the U.S. Renal Data System Database, a prospective study of 4,000 ESRD patients selected from a random sample of 25% U.S. dialysis facilities, to investigate these research questions. They found that married African American ESRD patients had marginally better outcomes on several clinical and psychosocial measures, which they hypothesize may be attributable to the instrumental and emotional support conferred by marriage.

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