A Mixed-Methods Approach to Understanding Variation in Social Support Requirements and Implications for Access to Transplantation in the United States

Keren Ladin*, Satia A. Marotta, Zeeshan Butt, Elisa J. Gordon, Norman Daniels, Tara A. Lavelle, Douglas W. Hanto

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Social support is a key component of transplantation evaluation in the United States. Social support definitions and evaluation procedures require examination to achieve clear, consistent implementation. We surveyed psychosocial clinicians from the Society for Transplant Social Workers and American Society of Transplant Surgeons about their definitions and evaluation procedures for using social support to determine transplant eligibility. Bivariate statistical analysis was used for quantitative data and content analysis for qualitative data. Among 276 psychosocial clinicians (50.2% response rate), 92% had ruled out patients from transplantation due to inadequate support. Social support definitions varied significantly: 10% of respondents indicated their center lacked a definition. Key domains of social support included informational, emotional, instrumental, motivational, paid support, and the patient’s importance to others. Almost half of clinicians (47%) rarely or never requested second opinions when excluding patients due to social support. Confidence and perceived clarity and consistency in center guidelines were significantly associated with informing patients when support contributed to negative wait-listing decisions (P =.001). Clinicians who excluded fewer patients because of social support offered significantly more supportive health care (P =.02). Clearer definitions and more supportive care may reduce the number of patients excluded from transplant candidacy due to inadequate social support.

Original languageEnglish (US)
JournalProgress in Transplantation
DOIs
StateAccepted/In press - Jan 1 2019

Keywords

  • access
  • and evaluation
  • candidate evaluation
  • disparities
  • ethics
  • ethics
  • health services research
  • health-care quality
  • heart
  • justice
  • kidney
  • liver
  • lung
  • mixed-methods
  • organ transplantation
  • psychosocial
  • psychosocial
  • qualitative
  • social support
  • social work
  • transplant candidate
  • transplant evaluation

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'A Mixed-Methods Approach to Understanding Variation in Social Support Requirements and Implications for Access to Transplantation in the United States'. Together they form a unique fingerprint.

  • Cite this