{"id":23840,"date":"2023-05-23T08:09:52","date_gmt":"2023-05-23T13:09:52","guid":{"rendered":"https:\/\/cdtrp.ca\/?p=23840"},"modified":"2023-05-23T08:09:52","modified_gmt":"2023-05-23T13:09:52","slug":"stagiaire-en-vedette-katya-loban","status":"publish","type":"post","link":"https:\/\/cdtrp.ca\/fr\/stagiaire-en-vedette-katya-loban\/","title":{"rendered":"Stagiaire en vedette : Katya Loban"},"content":{"rendered":"
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Stagiaire en vedette : Katya Loban<\/strong><\/span><\/h4>\n

Nous sommes ravis de f\u00e9liciter Katya Loban pour ses r\u00e9alisations exceptionnelles ! Katya pr\u00e9sentera trois r\u00e9sum\u00e9s lors de conf\u00e9rences \u00e0 venir : la Conf\u00e9rence 2023 de l’Association canadienne pour la recherche sur les services et les politiques de la sant\u00e9 (ACRSPS)<\/strong>, qui se tiendra \u00e0 Montr\u00e9al du 29 au 31 mai 2023, et l’American Transplant Congress<\/strong>, qui se tiendra \u00e0 San Diego du 3 au 7 juin 2023.<\/p>\n

Lors de la conf\u00e9rence de l’ACRSPS, Katya fera une pr\u00e9sentation orale sur le don vivant de rein intitul\u00e9e : \u00ab\u00a0Thank you for your kidney, good-bye.\u00a0\u00bb<\/em> : The Canadian living kidney donor perspective<\/em>. Lors de l’American Transplant Congress, elle participera \u00e0 une pr\u00e9sentation orale intitul\u00e9e \u00ab\u00a0Are We Providing Optimal Care, Information, and Support to Living Kidney Donors ? A Qualitative Study<\/em>\u00ab\u00a0. De plus, Katya pr\u00e9sentera \u00e9galement un poster intitul\u00e9 \u00ab\u00a0What I Desire from My Family Physician : The Living Kidney Donor Perspective<\/em>\u00ab\u00a0.<\/p>\n

Ces pr\u00e9sentations lors de conf\u00e9rences prestigieuses t\u00e9moignent du travail acharn\u00e9, du d\u00e9vouement et de l’expertise de Katya dans le domaine des soins de sant\u00e9. Nous saluons ses r\u00e9alisations et sommes impatients d’entendre les pr\u00e9cieuses id\u00e9es qu’elle ne manquera pas d’apporter.<\/p>\n

F\u00e9licitations, Katya !<\/p>\n<\/div>

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\u00c0 propos de Katya Loban<\/strong><\/h5>\n

Katya Loban est chercheuse en services de sant\u00e9. Elle est stagiaire postdoctorale \u00e0 l’Institut de recherche du Centre universitaire de sant\u00e9 McGill et au D\u00e9partement de m\u00e9decine de l’Universit\u00e9 McGill, sous la supervision de la Dre Shaifali Sandal. Katya est \u00e9galement stagiaire au sein du Programme de recherche en don et transplantation du Canada (PRDTC). Katya est titulaire d’un doctorat en m\u00e9decine familiale et soins primaires, d’un LLM en r\u00e9solution de conflits internationaux et d’un MA en d\u00e9veloppement organisationnel. Elle a 14 ans d’exp\u00e9rience professionnelle dans les domaines de la gestion de projets internationaux et de l’administration de la recherche. Katya s’int\u00e9resse notamment aux partenariats multilat\u00e9raux, \u00e0 la collaboration interprofessionnelle, aux aspects organisationnels des soins de sant\u00e9, ainsi qu’au droit m\u00e9dical et \u00e0 l’\u00e9thique. L’objectif de son projet postdoctoral actuel est d’explorer l’int\u00e9gration des soins primaires dans la trajectoire du don vivant, afin d’optimiser les soins prodigu\u00e9s aux donneurs vivants de rein.<\/p>\n<\/div>

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R\u00e9sum\u00e9 pour la Conf\u00e9rence 2023 de l’Association canadienne pour la recherche sur les services et les politiques de la sant\u00e9 (ACRSPS) – <\/strong>en anglais seulement<\/span><\/h4>\n
\u201cThank you for your kidney, good-bye.\u201d: The Canadian living kidney donor perspective<\/strong><\/h5>\n

K. Loban, J-T. Robert, P. Nugus, C. Rodriguez, S. Sandal<\/p>\n

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Background and objectives<\/strong>: Living donor kidney transplantation saves the Canadian healthcare system millions of dollars in averted dialysis costs, is the best treatment for kidney failure, and helps to narrow the persistent gap between the demand and supply of organs. Evidence suggests that this process is fraught with challenges for living kidney donors (LKDs). We aimed to obtain the perspectives of LKDs on their healthcare throughout the donation trajectory, with a focus on the role of primary care.<\/p>\n

Approach<\/strong>: This was a qualitative descriptive study, entailing 49 semi-structured interviews with LKDs. Adult male and female participants who spoke English or French and donated their kidney to someone they knew or anyone in need prior to 2020 were recruited via social media and email rosters from seven transplant jurisdictions in Canada. Interviews were conducted in person or via zoom. Interview questions related to perceived gaps in the provision of information on donation, experiences pre- and post-donation and the coordination of care among different healthcare providers. Data were analyzed using inductive content analysis.<\/p>\n

Results<\/strong>: LKD care lies at the intersection of primary and transplant care. Our analysis revealed: 1) variability in health information provision, 2) poor coordination between levels of care, and 3) gaps in post-donation care accessibility and comprehensiveness. Post-donation, most donors were under the care of their family physicians, some had limited annual follow-ups with transplant teams, and a minority of donors lacked access to care altogether. Many donors felt abandoned by the transplant teams. Those LKDs who felt \u201chealthy\u201d perceived follow-up by family physicians as acceptable, although many noted significant gaps in the knowledge of family physicians regarding LKD care. A key challenge identified was a lack of ongoing support for mental health<\/p>\n

Conclusion<\/strong>: This study suggests that in Canada, a country with universal health care, LKDs have unmet needs. Its results underscore the need for stronger integrative models of primary and tertiary care, with the living donor at their core. In addition, targeted medical education initiatives for primary care practitioners are needed.<\/p>\n<\/blockquote>\n<\/div>

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R\u00e9sum\u00e9s pour l’American Transplant Congress<\/strong> (en anglais seulement)<\/span><\/h4>\n
Are we providing optimal care, information, and support to living kidney donors? A qualitative study<\/strong><\/h5>\n

K. Loban, J-T. Robert, H. Badenoch, A. Bugeja, P. Nugus, C. Rodriguez, S. Sandal<\/p>\n

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Purpose:<\/strong> Living kidney donors (LKDs) experience several challenges when pursuing donation and their follow-up care is suboptimal. Data from the US have demonstrated that many centers are not in compliance with the Organ Procurement and Transplantation Network\/United Network for Organ Sharing mandated follow-up of LKDs and that lack of health insurance may play a role. Thus, we wanted to explore the experiences and needs of LKDs in Canada as they transition through the five phases of their donation trajectory.<\/p>\n

Methods:<\/strong> This was a pan-Canadian qualitative descriptive study, entailing 49 semi-structured interviews with LKDs who were recruited via social media or email rosters. Data were analyzed using inductive thematic analysis.<\/p>\n

Results: <\/strong>Participants reported: 1) unmet health information needs prior to donation, 2) poor coordination and lack of continuity between primary care and transplant teams, 3) inconsistency in post-donation care protocols, 4) challenges with access to care post-donation, and 5) suboptimal long-term follow-up. Post-donation most donors were under the care of their family physicians, some had annual follow-ups with transplant teams exclusively for monitoring remaining kidney function, and a minority of donors lacked access to care altogether. Many donors often felt abandoned by the transplant teams post-donation, particularly in light of very intense screening and evaluation leading to surgery. Those LKDs who felt \u201chealthy\u201d perceived follow-up by family physicians as acceptable, although many noted significant gaps in the knowledge of family physicians regarding donor care. A key challenge identified by nearly all donors was a lack of ongoing support for mental health.<\/p>\n

Conclusions:<\/strong> We report that even in a country with universal health care, LKDs have unmet needs. Our data can inform targeted multi-disciplinary interventions to improve care coordination, facilitate early detection of problem symptoms and enhance the experiences of LKDs which would, ultimately, lead to better short- and long-term patient outcomes.<\/p>\n<\/blockquote>\n<\/div>

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\u201cWhat I desire from my family physician\u201d: the living kidney donor perspective<\/strong><\/h5>\n

K. Loban, J-T. Robert, H. Badenoch, P. Nugus, C. Rodriguez, S. Sandal<\/p>\n

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Purpose:<\/strong> In the US, transplant centers are mandated by the Organ Procurement and Transplantation Network (OPTN) to follow living kidney donors (LKDs) for two years after donation, yet a majority of LKDs are lost to follow-up. LKDs are healthy individuals whose main health care contact prior to and after donation are primary care practitioners, such as family physicians (FPs). Better engagement of FPs can inform improved compliance with the OPTN policy as well as optimal long-term care of LKDs. We aimed to obtain the perspectives of LKDs on the role of FPs pre- and post-donation.<\/p>\n

Methods:<\/strong> This was a pan-Canadian qualitative descriptive study that aimed to obtain the perspectives of LKDs. We chose Canada as the setting for this study as lack of insurance is not a major barrier to access care. We conducted 49 semi-structured interviews with LKDs who were recruited via social media or email rosters. Data were analyzed using thematic analysis.<\/p>\n

Results:<\/strong> Having a FP was a prerequisite for being a LKD for most transplant programs. Post-donation, most LKDs were under the care of their FPs. In practice, the role of FPs was confined to occasional pre-donation physical screening and limited long-term follow-up. Participants reported poor coordination between primary and transplant care and significant gaps in the knowledge of FPs regarding living donation and long-term donor care. A few stated that their FPs implicitly or explicitly discouraged donation. Desired roles for FPs included health information brokerage, mental health support and long-term kidney function monitoring. Some illustrative quotes are highlighted in Table 1.<\/p>\n

Conclusions:<\/strong> We have identified several opportunities for improving long-term donor follow-up and care much beyond the two-year mandate from the OPTN. Given that LKDs are generally under the care of a FP pre- and post-donation, targeted medical education initiatives and stronger integrative models of primary and tertiary care are needed.<\/p>\n<\/blockquote>\n<\/div>

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