Experience of Hong Kong patients awaiting kidney transplantation in mainland China

• Published in: Journal of clinical nursing 2007-11, Vol.16 (11c), p.341-349
• Main Authors: Leung, Sylvie SH, Shiu, Ann TY
• Format: Article
• Language: English
• Subjects: Adult; Aged; Asian people; China; chronic kidney disease; Decision Making; Female; Health care delivery; Hong Kong; Humans; Interviews as Topic; Kidney diseases; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Kidney Transplantation; Male; Middle Aged; Nurse-Patient Relations; nurses; Nursing; Physician-Patient Relations; Qualitative research; Quality of Life - psychology; Renal Dialysis; Time Factors; transplantation; Transplants & implants; Travel
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/j.1365-2702.2007.02070.x

Aim.  This paper describes the experience of Hong Kong Chinese patients awaiting kidney transplantation in mainland China. Background.  While travelling to mainland China for kidney transplantation is a controversial issue, there is an increasing trend of Hong Kong Chinese patients with chronic kidney disease seeking this treatment choice, which outnumbers that performed in Hong Kong. Although these patients seek pre‐ and post‐transplantation care from Hong Kong public healthcare system, little is known about their experience during the waiting period. Methods.  This experience is examined in an exploratory qualitative study. In‐depth interviews were used to collect data from a purposive sample of 12 kidney recipients. Results.  Three major findings are identified: (i) transplant waiting patients may travel to mainland China for transplantation in search of normal life, (ii) they need informational support from their continuing healthcare providers in Hong Kong to make the informed decision and (iii) they perceive a variation of attitudes of nurses and doctors in Hong Kong towards transplantation in mainland China. Conclusions.  This study contributes to the literature by researching patients’ perspective. The findings highlight the importance and controversy of addressing these patients’ informational needs. While the authors have no inclination for or against travelling to mainland China for transplantation, the findings reveal a tenacious clinical dilemma, which deserves debate in international transplant community and further research to inform the debate. Nurse and doctors in Hong Kong may contribute to the debate by articulating their experience of caring for these patients. Relevance to clinical practice.  Health information that is readily available for patients scheduled for kidney transplantation in Hong Kong should be made accessible to the whole community of patients with chronic kidney disease. To address the complexity of patients travelling to elsewhere for transplantation and the needs of these patients, provider reticence may be counterproductive.