Nursing Perceptions and Live Kidney Donation Research

Introduction: The Organ Shortage Problem

Organ transplant is an area of medical treatment with the capacity to save lives, but a significant set of challenges prevents transplant from being employed as early and as often as desired. The noted gap between what is needed and what is available to the medical community has created a highly deficient waiting-list system, in which would-be recipients are in a slow race against pressing health ailments that require timely organ transplant. According to research by Neyhart and Colaneri (2004), "the incidence of patients diagnosed with end-stage renal disease (ESRD) has far exceeded the supply of kidneys. Cadaveric kidney donations have reached a plateau. Live donor kidneys are a source that could be expanded if the American public and the health care community would accept and promote the idea of living anonymous donation (LAD)" (Neyhart & Colaneri, p. 1).

This reality drives the need for more aggressive recruitment of live kidney donors. Because live donation is feasible for the donor and produces significantly better outcomes for the patient, it is the preferred method of treatment for those with critical renal failure. For nurses working in this context, the critical shortage of available live kidney donors creates a less-than-optimal public health outlook. The resulting nursing problem is twofold: improving the availability of live donated kidneys while simultaneously addressing this issue with careful attention to the persistent ethical implications it raises.

Relevance to Nursing Practice

According to research by Conesa et al. (2009), there is distinct value in understanding the disposition of nurses toward different methods of recruiting live kidney donors, with respect to improving organ availability for transplant. As Conesa et al. note, "nursing is a fundamental service in caring for the health of the public. The opinion of nurses toward a certain type of donation may have a strong population impact. In this respect, living kidney donation is increasing in Spain; it is important to raise awareness at all levels" (Conesa et al., p. 3626).

This underscores the relevance of the subject to the nursing profession, which is demonstrated to have a direct bearing on the way that potential donors perceive the social, medical, and practical implications of making such a donation. For the purposes of this research, the connection between nursing perceptions and public perceptions will drive the nature of the study and provide purpose to the findings thereby produced.

Research Objectives and Expected Outcomes

The primary objective of the proposed research is to heighten emphasis on those methods of donor recruitment that appear to correspond with the practical and ethical concerns of most nurses. This speaks to the immediate intention of establishing a fuller understanding of how nurses perceive and respond to several available methods of kidney donation, based on their practical experience with transplant patients and their individual ethical perspectives. All indications suggest that nurses tend to view live kidney donation positively when it conforms to a certain set of conditions. Most particularly, the study by Conesa et al. finds that "the attitudes toward living kidney donation were favorable in 93% of those questioned (n = 129), mainly when the donation is related (78%, n = 109)" (Conesa et al., p. 3630).

This means that, at the most basic level, we enter the discussion recognizing that nursing professionals largely support the benefits achieved through kidney transplant where the donor is a living subject. The same study noted no preference of relationship with respect to non-living donors. This is a useful point of distinction as we consider the objective of this research: to find common ground between nurses' favorable perspective and the various live-donation recruitment methods that are distinct from traditional family-relation approaches. It will therefore be necessary to determine how nurses respond to alternate recruitment methods, such as the use of online media, financial incentives, and outreach to foreign markets where there appears to be greater public willingness to donate.

It is anticipated that the research will reveal a significant level of support among nurses for a broader effort to spread information and extend recruitment to reach a wider range of potential organ donors. A relative consensus on this subject is likely, given the genuine shortage of available live kidney donors and the unique benefits that living donors provide for dialysis patients and those with end-stage renal failure. Some divided sentiment is anticipated regarding the use of financial compensation as a recruitment tool, consistent with general findings in the existing literature.