Why do people say “no” to a kidney transplant? Understanding patient decision making and choice – PhD Scholarship

Why do people say “no” to a kidney transplant? Understanding patient decision making and choice.

Bangor University, School of Health Sciences

Project ID: BUK2E040
Annual Stipend: £14,483
Application Deadline: February 21st. 2020

Kidney transplantation is considered the gold standard modality of renal replacement therapy (RRT), providing the best long term outcomes for patients with end-stage renal disease (ESRD).  Nevertheless, some eligible patients refuse transplantation and the reasons are unclear.  A recent Betsi Cadwaladr University Health Board (BCUHB) audit looking into kidney transplants revealed that BCUHB is only transplanting 50-70% of eligible patients compared to the national prevalence.  BCUHB also has the highest reported rate of kidney transplant work up or uptake declined in Wales.

Current literature indicates that transplantation choice appears to be a complex interaction of multiple factors but current research has many shortcomings, with disparate results, conflicting conclusions and little research undertaken in a UK context.  Furthermore most data has been collected and analysed using quantitative methodology via questionnaires or renal registry information. Indeed, little has been investigated regarding the role of psychological, relational and social issues, or practicalities/logistics for patients/renal services.

To address this gap, applications are invited from students to undertake qualitative research to address the following questions:

  1. What are the reasons why potentially eligible patients decline a kidney transplant or disengage from the transplant work up process?
  2. What would promote a shared understanding between patients and health care providers about the decisions and choices made when considering the option of a kidney transplant?

The successful applicant will undertake a review of the literature, interviews with BCUHB patients (pre and post-transplant) and multi-disciplinary renal health care professionals. Undertake data analysis, present outcomes to multi-disciplinary audiences and support interpretation of findings to develop clinical tool kits to support shared decision making in renal transplant.

Essential Criteria:

  • Undergraduate or Masters degree, ideally in a psychology, health or social sciences subject (but applicants from other disciplines should not be discouraged due to the multidisciplinary nature of this research)
  • Enthusiasm for research and wanting to extend research skills
  • Good communication skills
  • Appreciation of the bilingual context of Wales
  • A full driving licence

Desirable criteria;

  • Knowledge of health decision making models
  • Enthusiasm for renal health and wellbeing
  • Experience working as part of a multi-disciplinary team
  • Previous experience of qualitative research
  • Welsh speaker

The studentship will be based at Bangor University with significant time spent at BCUHB 3 renal centres in Ysbyty Gwynedd, Bangor, Ysbyty Wrexham Maelor, Wrexham and Ysbyty Glan Clwyd, Bodlwyddan.  Applicants may also be required to travel to South Wales.

The primary supervisors are Professor Jane Noyes, Professor of Health and Social Service, School of Health Sciences, Bangor University (jane.noyes@bangor.ac.uk)  and Dr Kate Shakespeare, Clinical Psychologist; Ysbyty Glad Clwyd Renal and Diabetes Centre (Kate.Shakespeare@wales.nhs.uk). The project is an exciting opportunity to join a collaboration between Bangor University, BCUHB, the Wales Kidney Research Unit and kidney charity partners, including Kidney Wales who study various aspects of the health and social contexts of kidney disease across Wales.  The full studentship proposal and protocol is available online here and should be reviewed prior to applying http://kidneyresearchunit.wales/impact-case-studies.htm?id=33.

To apply:

Please email a current CV and covering letter (2 A4 pages maximum) to Jane Noyes (jane.noyes@bangor.ac.uk) and cc to Penny Dowdney (p.j.dowdney@bangor.ac.uk). The closing date for applications is February 21st. The start date of the project is at the latest 1st April 2020 and will last for 3 year(s). For informal inquiries, please contact Prof Jane Noyes.

KESS 2 East is a pan-Wales higher level skills initiative led by Bangor University on behalf of the HE sector in Wales. It is part funded by the Welsh Government’s European Social Fund (ESF) convergence programme for East Wales.

Due to ESF funding, eligibility restrictions apply to this scholarship. To be eligible, the successful candidate will need to be resident in East Wales on University registration, and must have the right to work in the region on qualification.