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Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews

BACKGROUND AND OBJECTIVES: Many donors and recipients report an improved bond posttransplantation; however, unexpected conflicts and tension may also occur. Insights into the lived experiences of the donor–recipient relationship can inform strategies for interventions and support. We aimed to descri...

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Autores principales: Ralph, Angelique F, Butow, Phyllis, Craig, Jonathan C, Wong, Germaine, Chadban, Steve J, Luxton, Grant, Gutman, Talia, Hanson, Camilla S, Ju, Angela, Tong, Allison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500358/
https://www.ncbi.nlm.nih.gov/pubmed/30948607
http://dx.doi.org/10.1136/bmjopen-2018-026629
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author Ralph, Angelique F
Butow, Phyllis
Craig, Jonathan C
Wong, Germaine
Chadban, Steve J
Luxton, Grant
Gutman, Talia
Hanson, Camilla S
Ju, Angela
Tong, Allison
author_facet Ralph, Angelique F
Butow, Phyllis
Craig, Jonathan C
Wong, Germaine
Chadban, Steve J
Luxton, Grant
Gutman, Talia
Hanson, Camilla S
Ju, Angela
Tong, Allison
author_sort Ralph, Angelique F
collection PubMed
description BACKGROUND AND OBJECTIVES: Many donors and recipients report an improved bond posttransplantation; however, unexpected conflicts and tension may also occur. Insights into the lived experiences of the donor–recipient relationship can inform strategies for interventions and support. We aimed to describe donor and recipient expectations and experiences of their relationship before and after living kidney donor transplantation. DESIGN, SETTING AND PARTICIPANTS: Semistructured interviews were conducted with 16 donor–recipient pairs before the transplant and 11–14 months post-transplant. Transcripts were analysed thematically. RESULTS: We identified seven themes (with respective subthemes): donation as enacting familial responsibility for care; analytical decision making to mitigate regret (avoiding anticipated regret and maintaining control, removing emotional impulsivity); strengthened interpersonal ties (gaining a deeper appreciation among family members, stronger empathy for each other, improving social participation); instability of relational impacts (anger and aggression threatening dynamics, unanticipated stress and emotional lability, triggering familial tension); renegotiating social roles (unexpected continuation of caregiving responsibilities, inability to relinquish the caregiving role, disappointment with unfulfilled renewal of intimacy, dissatisfaction over discrepant energy levels); guilt over unmet expectations and inevitability of the gift relationship (vague and transient indebtedness, expectation of reciprocity, transferring kidney ownership). CONCLUSIONS: Donor–recipient relationships may be improved through increased empathy, appreciation, and ability to participate in life together; however, unfulfilled expectations and behavioural and emotional changes in recipients (a side effect related to immunosuppression) remain unresolved consequences of living kidney donor transplantation. Education and counselling to help donors and recipients adjust to potential changes in relationship dynamics may help protect and foster relational stability postdonation.
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spelling pubmed-65003582019-05-21 Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews Ralph, Angelique F Butow, Phyllis Craig, Jonathan C Wong, Germaine Chadban, Steve J Luxton, Grant Gutman, Talia Hanson, Camilla S Ju, Angela Tong, Allison BMJ Open Renal Medicine BACKGROUND AND OBJECTIVES: Many donors and recipients report an improved bond posttransplantation; however, unexpected conflicts and tension may also occur. Insights into the lived experiences of the donor–recipient relationship can inform strategies for interventions and support. We aimed to describe donor and recipient expectations and experiences of their relationship before and after living kidney donor transplantation. DESIGN, SETTING AND PARTICIPANTS: Semistructured interviews were conducted with 16 donor–recipient pairs before the transplant and 11–14 months post-transplant. Transcripts were analysed thematically. RESULTS: We identified seven themes (with respective subthemes): donation as enacting familial responsibility for care; analytical decision making to mitigate regret (avoiding anticipated regret and maintaining control, removing emotional impulsivity); strengthened interpersonal ties (gaining a deeper appreciation among family members, stronger empathy for each other, improving social participation); instability of relational impacts (anger and aggression threatening dynamics, unanticipated stress and emotional lability, triggering familial tension); renegotiating social roles (unexpected continuation of caregiving responsibilities, inability to relinquish the caregiving role, disappointment with unfulfilled renewal of intimacy, dissatisfaction over discrepant energy levels); guilt over unmet expectations and inevitability of the gift relationship (vague and transient indebtedness, expectation of reciprocity, transferring kidney ownership). CONCLUSIONS: Donor–recipient relationships may be improved through increased empathy, appreciation, and ability to participate in life together; however, unfulfilled expectations and behavioural and emotional changes in recipients (a side effect related to immunosuppression) remain unresolved consequences of living kidney donor transplantation. Education and counselling to help donors and recipients adjust to potential changes in relationship dynamics may help protect and foster relational stability postdonation. BMJ Publishing Group 2019-04-04 /pmc/articles/PMC6500358/ /pubmed/30948607 http://dx.doi.org/10.1136/bmjopen-2018-026629 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Renal Medicine
Ralph, Angelique F
Butow, Phyllis
Craig, Jonathan C
Wong, Germaine
Chadban, Steve J
Luxton, Grant
Gutman, Talia
Hanson, Camilla S
Ju, Angela
Tong, Allison
Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
title Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
title_full Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
title_fullStr Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
title_full_unstemmed Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
title_short Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
title_sort living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews
topic Renal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500358/
https://www.ncbi.nlm.nih.gov/pubmed/30948607
http://dx.doi.org/10.1136/bmjopen-2018-026629
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