The living donor study: the concepts and frames of living kidney donors

Cunningham, Aimee Catalan (2015). The living donor study: the concepts and frames of living kidney donors PhD Thesis, School of Communication and Arts, The University of Queensland. doi:10.14264/uql.2015.602

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Author Cunningham, Aimee Catalan
Thesis Title The living donor study: the concepts and frames of living kidney donors
School, Centre or Institute School of Communication and Arts
Institution The University of Queensland
DOI 10.14264/uql.2015.602
Publication date 2015-05-08
Thesis type PhD Thesis
Open Access Status Other
Supervisor Joan Leach
Susan McKay
Total pages 268
Language eng
Subjects 200101 Communication Studies
220106 Medical Ethics
200403 Discourse and Pragmatics
Formatted abstract
This thesis explores the concepts and frames of living kidney donors through the use of recorded and transcribed conversations between living kidney donor patients and their transplant team. It offers insight into the expectations of living kidney donors as they prepare themselves to gift a kidney to someone they know. Living kidney donor frames are represented as particularly resilient and well-defined, shielding them from messages delivered by their transplant team. Those frames incorporate their acceptance as living kidney donors, the risk to themselves and their own personal definitions of autonomy and choice.

With the intention of using phenomenological discourse analysis to examine the recorded and transcribed data, ten potential living kidney donors and their recipients were invited to take part in a PhD project entitled the Living Donor Study at the Princess Alexandra Hospital, in Queensland Australia. Transcriptions were analysed using line-by-line and axial coding and living donor transcripts were repeatedly compared with one another in order to reach an appropriate level of saturation and provide evidence of re-emerging concepts and frames.

Data for the Living Donor Study were obtained during the living kidney donor’s initial transplant assessment clinic visit. The purpose of this project was to examine prospective accounts of the living donation experience using conversations with their transplant team as opposed to using retrospective questionnaires and interviewing methods. By eliminating much of the subjectivity that is common in ex post facto interviews, I was able to identify many of the concepts that assist living kidney donors in framing their experience and how those frames impact upon their expectations of the transplant assessment clinic and their upcoming donation.

Additional findings within the Living Donor Study include how fundamentally different frames regarding informed consent and patient risk were exhibited by the transplant team compared to those of the living kidney donor cohort. This created a complex asymmetry that not only encompassed differing patient and clinician expectations but also stemmed from the unusual dynamic of a healthy patient in consultation with their doctor as opposed to a sick one seeking treatment.

This research assists in creating a better understanding of living kidney donor expectations and will have implications with respect to how transplant experts may choose to review their interactions with their donor patients. Further it identifies how the tightly held living donation frames of the transplant team prevent them from fully acknowledging the manner in which living kidney donor patients regard informed consent, autonomy and personal choice.

Based upon the declarations made by living kidney donors during the transplant clinic and the manner in which they volunteered information and answered questions posed to them by their team, living kidney donors have a well-entrenched set of expectations about their donation and their ability to manage their agendas and perception of risk is well developed.
Keyword Living kidney donation
Discourse analysis
Patient frames

Document type: Thesis
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Created: Tue, 05 May 2015, 14:51:52 EST by Aimee Cunningham on behalf of Scholarly Communication and Digitisation Service