Construction of an Index System for Assessing Competences of Transplant Coordinators in China: A Delphi Survey.

BACKGROUND: Transplant coordinators (TCs) play a pivotal role in the entire donation process. Their professional competences have a direct impact on donation rates. However, few specific indicators are available for assessing TCs' professional competence. Therefore, it is imperative to develop an assessment index system to measure their competence. Our objective was to construct an index system for assessing TCs' professional competences. METHODS: Based on a literature review and semistructured interviews, a focus group and 12 TCs were enrolled to design the questionnaires. Then, a modified Delphi method was used. Two rounds of questionnaires were distributed to 21 experts from 7 provinces across multiple research areas between October 2020 and March 2021. The data were sorted and analyzed by a focus group. RESULTS: A combined assessment index system, namely, APT, including 3 constructs, the admittance assessment model (henceforth A), practical operation assessment model (P), and thousand-point performance assessment model (T), was constructed. This APT index system consisted of 3 first-level items, 8 second-level items, and 34 third-level items. CONCLUSIONS: The APT assessment system has been unanimously recognized by experts. This index system, as a precursor form, will further lay the foundation for formation of an assessment instrument and provide references for other countries.

Exploration of Profession Experience Among In-Hospital Organ Procurement Coordinators in China: A Qualitative Study.

BACKGROUND: The gap between the supply and demand of organs is continuously increasing. The emergence of organ procurement coordinators (OPCs), to a certain extent, has decreased the gap. In China, a majority of OPCs work in hospitals that are qualified for transplants, namely in-hospital OPCs (Ih-OPCs). Their profession experiences are closely related to donation rates and indirectly reveal aspects that should be further improved. However, no data are available in China. We sought to explore Ih-OPCs' subjective feeling of the practice experience and provide targeted interventions for administrators. METHODS: A project team was established and then interview outlines were listed by virtue of discussion and literature review. Furthermore, a total of 13 Ih-OPCs were selected as participants for interview. After that, the conversation was analyzed and encoded, and themes were finally identified according to phenomenology. RESULTS: A total of 3 themes including positive emotions, negative emotions, and personal needs were identified, which were furthermore divided into 7 minor themes ranging from professional identity, competence improvement, recruitment methods, quality of life, workload evaluation, career prospects, and training courses. CONCLUSIONS: Social support and public understanding play a pivotal role in strengthening positive emotions. Meanwhile, the administrators should put more emphasis on negative emotions and personal needs, and management system should be further optimized.

Factors promoting shared decision-making in renal replacement therapy for patients with end-stage kidney disease: systematic review and qualitative meta-synthesis.

PURPOSE: Shared decision-making (SDM) about the type of renal replacement therapy to use is a matter of great importance involving patients, their families, and health treatment teams. This review aims to synthesize the volume of qualitative work explaining the factors influencing SDM regarding renal replacement therapy. METHODS: A systematic review and qualitative meta-synthesis approach recommended by JBI was used, six databases were searched. Studies were qualitative or mixed research published since 2000, with a primary focus on patient experiences, perceptions and practices regarding which method to choose for renal replacement therapy in End-Stage Kidney Disease (ESKD) patients. All themes were analyzed and compared to the established connectedness. RESULTS: A total of 1313 patients were enrolled in 32 studies focusing on factors associated with SDM regarding renal replacement therapy were included. All quality evaluations of the literature were medium to high. Four common themes were identified in our synthesis: (1) patient personal reasons, (2) family-related factors, (3) health care professional-related factors, and (4) social factors influence. CONCLUSION: The model proposes pathways that could be explored further in future qualitative and quantitative studies and suggests that patients' beliefs, emotions, and awareness should be targeted alongside patients' decision-making practices to increase the efficacy of interventions. The majority of studies included in this review focus on older patients, and all report patients' perspectives. Further research is required to understand the family member perspectives on SMD of renal replacement therapy.