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Processes of knowing in the translation of a health communication intervention for dialysis patients awaiting kidney transplantation
Authors:Marit Helen Andersen  Kristin Hjorthaug Urstad  Marie Hamilton Larsen  Eivind Engebretsen  John Ødemark  Anne Eriksen  Astrid Klopstad Wahl
Affiliation:1. Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway;2. Faculty of Medicine, Department of Interdisciplinary Health Sciences, University of Oslo, Norway;3. Faculty of Health Sciences, University of Stavanger, Stavanger, Norway;4. Lovisenberg Diaconal University College, Oslo, Norway;5. Faculty of Humanities, IKOS, University of Oslo, Oslo, Norway;1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany;2. Faculty of Human Sciences and Faculty of Medicine, Graduate School GROW – Gerontological Research on Well-being, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany;3. Federal Centre for Health Education, Maarweg 149-161, 50825, Cologne, Germany;4. Department for General Medicine and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany;5. Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany;6. Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany;1. Johns Hopkins University School of Medicine, Baltimore MD – 733 N Broadway, Baltimore, MD, 21205, USA;2. University of Maryland School of Medicine, Baltimore MD – 655 W Baltimore St S, Baltimore, MD, 21201, USA;3. Children’s National Medical Center, Washington DC – 110 Irving St NW, Washington, DC, 20010, USA;1. Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain;2. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain;3. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain;4. Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain;5. Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain;6. Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain;7. SAP Delta Llobregat, DAP Costa Ponent, Institut Català de la Salut (ICS), Catalonia, Spain;8. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain;9. Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain;10. Pompeu Fabra University (UPF), Barcelona, Spain;1. High Point University, Fred Wilson School of Pharmacy, Department of Clinical Sciences, United States;2. Department of Pharmacy Practice & Administration, Western University of Health Sciences, College of Pharmacy, United States;1. Icahn School of Medicine at Mount Sinai, New York, NY, United States;2. Department of Psychology, Pace University, New York, NY, United States;3. ISO, Verisk Analytics, Jersey City, NJ, United States;4. Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai, New York, NY, United States;5. International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States;6. Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States;7. Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States;8. Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States;1. Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France;2. Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France;3. Department of Digestive and Oncological Surgery, University of Lille, Claude Huriez University Hospital, Lille, France;4. Department of General Oncology, Centre Oscar Lambret, Lille, France;5. Department of Medical Oncology, University of Lille, Claude Huriez University Hospital, Lille, France;6. University of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020 – UMR-S 1277 – Canther – Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000, Lille, France;7. Jean-Pierre Aubert Research Center, Neurosciences and Cancer, University of Lille, IMR-S 1172-JPArc, Lille, France
Abstract:ObjectiveTo strengthen patients’ health literacy and their role as active knowledge actors, we developed a health communication intervention including a film-viewing and counselling session for patients awaiting kidney transplantation. We aimed to explore processes of knowing in the translation of the intervention.MethodsWe applied an ethnographic research approach, observing nine intervention sessions with patients and dialysis nurses. Afterwards, the patients and the nurses were interviewed in-depth. Data were analysed using Engebretsen’s modified version of Lonergans’ four-step model of knowing.ResultsThe following knowing processes were identified: i) Knowing as meaning-making; ii) Knowing as acquiring confidence; and iii) Accessing professionals’ and peer experts’ knowledge. Divergent considerations were taken by the different knowledge actors, which had a direct influence on the knowing processes and knowledge translation.ConclusionsThe findings support active interactions between patients and healthcare providers in processes of knowing. These include self-conscious approaches and critical questioning in both parties.Practice implicationsFor transplant professionals, this study demonstrates knowing processes in a real-life context. It also spotlights professional skills and attitudes regarding the importance of self-conscious questioning and a critical interrogating position (for both patients and providers).
Keywords:Health communication intervention  Knowledge translation  Health literacy  Dialysis patients  Kidney transplantation
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