Psychological Experiences Of Transplantation In Kidney Recipients

Objective:Kidney recipients undergo a complex psychological process, including organ integration and processing of attitudes towards the organ donor. Therefore, we aimed to evaluate their personal post-transplant experiences in adult kidney recipients.Methods:1. Three hundred and three consecutive kidney recipients were asked to participate in a cross-sectional questionnaire study on the psychological processing of kidney transplants. The questionnaire consisted of statements describing aspects of organ integration and the patient’s relationship with the donor. Furthermore, the personality traits of the patients were assessed.2. A semi-structured interview was carried out on the basis of a manual containing six questions in total. The questions referred to patients’perceptions of their self, donor, transplanted kidney and their subjective experience relate to the current perceived importance of transplanted events, the advice to the organ integration. Interviewees were accessed by purpose sampling and theoretical sampling. These interviews were evaluated by the grounded theory method. Thirty kidney transplant recipients were interviewed until the categories and codes were saturated. Nvivo10qualitative data management and analysis sortware was used to assist the data analyzed process.Results:1. In general, kidney recipients perceive the transplant as part of themselves (84.2%) and not as a foreign object (66.7%),49.2%of the patients still have frequent thoughts about the donor, whilst the majority (80.2%) does not believe that they have adopted the donor’s characteristic traits. Factor analysis reveals the two-dimensional structure of the questionnaire items’organ integration’(factor1) and’relationship to the donor’(factor2). There is significant correlation between organ integration and family income, time since transplantation, personality and serum creatinine level. Family incomes, the state of occupation, living area, insurance status, marital status, kidney procurement, and serum creatinine level are found to be correlated with "relationship to the donor". Personality and pulmonary infection predict organ integration, whilst education years, personality, time since transplantation, live donor kidney transplantation, rejection and admission times predict "relationship to the donor". Organ integration and relationship to the donor have an impact on serum creatinine level, admission times, complications and pulmonary infection.2. The recipients’ complex and unique experiences of their transplanted kidneys can be arranged under three themes:organ integration, coping and individual reactions. The stages of integration are foreign body stage, stage of partial incorporation and stage of complete incorporation; live donor kidney transplantation, time since transplantation, psychological and physical factors can affect these stages. A coping strategy that we have seen involves an attempt to repress, avoid the organ that has been presented to him. Individual reaction means the mental processes from the initial stage to adaptation. The majority does not believe that they have adopted the donor’s characteristic traits. Gratitude and guilt responses are common in kidney recipients. They are constantly mindful of their new kidney, and they give some reasonable advice for organ integration.Conclusions:It is the first time that the mixed methods study design was used to systematically explore the psychological experiences of transplantation in kidney recipients. The study shows that both organ integration and donor relationship have significant correlations with the patient’s physio-psychological health. Our study provided important implications to clinical practice and research for kidney recipients.