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Psychosocial criteria in Australian practice guidelines for determining patient suitability for kidney transplantation

Anderson, Kate, Cass, Alan, Cunningham, Joan, Snelling, Paul L., Devitt, Jeannie, Eris, Josette and Preece, Cilla (2006). Psychosocial criteria in Australian practice guidelines for determining patient suitability for kidney transplantation. In: Twenty-fourth Annual Scientific Meeting of the Transplantation Society of Australia and New Zealand, Canberra, March 2006.

Document type: Conference Paper
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Author Anderson, Kate
Cass, Alan
Cunningham, Joan
Snelling, Paul L.
Devitt, Jeannie
Eris, Josette
Preece, Cilla
Title Psychosocial criteria in Australian practice guidelines for determining patient suitability for kidney transplantation
Conference Name Twenty-fourth Annual Scientific Meeting of the Transplantation Society of Australia and New Zealand
Conference Location Canberra
Conference Dates March 2006
Conference Publication Title Proceedings of the Twenty-fourth Annual Scientific Meeting of the Transplantation Society of Australia and New Zealand
Publication Year 2006
Field of Research 320000 Medical and Health Sciences
Abstract Psychosocial criteria are increasingly being included in practice guidelines for determining patient suitability for kidney transplantation. Although intended to promote evidence-based decision-making, if poorly defined, the inclusion of psychosocial criteria has the potential to reduce transparency in patient selection and equity of access. We reviewed all Australian practice guidelines concerning patient suitability for kidney transplantation and qualitatively analysed their inclusion of, and approach towards, psychosocial criteria.

Transplant Directors from all Australian adult transplant units were invited to submit their unit's guidelines for this national research audit. All 16 units (100%) submitted some form of documentation. We analysed only those documents that were purposely structured tools for directing patient selection (eight guidelines used in 10 transplant units). Content analysis was performed on the abstracted psychosocial criteria. Psychosocial criteria—particularly non-compliance and smoking—were commonly included. In general, the psychosocial criteria were ill-defined and lacking in substantiating evidence and recommendations for assessment or action.

Our results reveal that current Australian patient selection guidelines for kidney transplantation incorporate poorly defined psychosocial criteria that vary greatly. Furthermore, there appears to be a weak evidence base underpinning their inclusion. The use of psychosocial criteria in this manner decreases the transparency of patient selection and increases the potential for subjective estimates of social worth to influence patient selection. The priority given to such criteria in transplant guidelines requires attention and debate.
Keyword Australian
Kidney
Kidney Transplantation
psychosocial criteria
transplantation
Additional Notes 4385 (Generic Abstract)
 
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Created: Mon, 17 Dec 2007, 09:02:11 CST