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Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients
Kidney transplantation is regarded as the best treatment option for patients with end-stage renal disease. However, living-donor recipients (LDRs) and deceased-donor recipients (DDRs) still face challenges in transplant-specific emotional adjustment post-transplantation. Research distinguishing emot...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004627/ https://www.ncbi.nlm.nih.gov/pubmed/32095515 http://dx.doi.org/10.1097/TXD.0000000000000956 |
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author | Lai, Yousheng Lester Neo, Hui Ling Michelle Vathsala, Anantharaman Griva, Konstadina |
author_facet | Lai, Yousheng Lester Neo, Hui Ling Michelle Vathsala, Anantharaman Griva, Konstadina |
author_sort | Lai, Yousheng Lester |
collection | PubMed |
description | Kidney transplantation is regarded as the best treatment option for patients with end-stage renal disease. However, living-donor recipients (LDRs) and deceased-donor recipients (DDRs) still face challenges in transplant-specific emotional adjustment post-transplantation. Research distinguishing emotional adjustment between transplant groups has been limited to Western settings, with little attention given to Asian populations. As such, documenting and comparing the emotional adjustment of LDRs and DDRs in an ethnically diverse Asian setting in Singapore and identifying factors associated with emotional adjustment are of interest. METHODS. One hundred eighty-two kidney transplant patients (106 LDRs and 76 DDRs) completed measures of generic distress (Depression, Anxiety, Stress Scale-21) and transplantation-specific emotional and behavioral outcomes (Transplant Effects Questionnaire). RESULTS. LDRs were significantly younger (P = 0.019) and had higher education levels (P = 0.007), higher personal income (P < 0.001), shorter dialysis vintage (P < .001), and higher estimated glomerular filtration rates (eGFRs) (P = 0.002) compared with DDRs. Generic symptoms of depression and stress were very low; however, 29.2% of LDRs and 19.7% of DDRs experienced moderate to severe symptoms of anxiety. Similarly, 83.0% of LDRs and 72.4% of DDRs reported high levels of transplant-specific worry. Multivariate models showed younger patients expressing greater generic distress, and transplant-specific worry (P < 0.01), despite higher eGFRs (P < 0.05). ANCOVA controlling for casemix differences showed that LDRs experienced higher feelings of guilt (P = 0.004) and greater willingness to disclosure (P = 0.041). CONCLUSIONS. Clinicians should be vigilant of younger kidney transplant patients who have greater risk of poorer emotional adjustment. Future interventions should target alleviating anxiety and transplant-specific worry. |
format | Online Article Text |
id | pubmed-7004627 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-70046272020-02-24 Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients Lai, Yousheng Lester Neo, Hui Ling Michelle Vathsala, Anantharaman Griva, Konstadina Transplant Direct Kidney Transplantation Kidney transplantation is regarded as the best treatment option for patients with end-stage renal disease. However, living-donor recipients (LDRs) and deceased-donor recipients (DDRs) still face challenges in transplant-specific emotional adjustment post-transplantation. Research distinguishing emotional adjustment between transplant groups has been limited to Western settings, with little attention given to Asian populations. As such, documenting and comparing the emotional adjustment of LDRs and DDRs in an ethnically diverse Asian setting in Singapore and identifying factors associated with emotional adjustment are of interest. METHODS. One hundred eighty-two kidney transplant patients (106 LDRs and 76 DDRs) completed measures of generic distress (Depression, Anxiety, Stress Scale-21) and transplantation-specific emotional and behavioral outcomes (Transplant Effects Questionnaire). RESULTS. LDRs were significantly younger (P = 0.019) and had higher education levels (P = 0.007), higher personal income (P < 0.001), shorter dialysis vintage (P < .001), and higher estimated glomerular filtration rates (eGFRs) (P = 0.002) compared with DDRs. Generic symptoms of depression and stress were very low; however, 29.2% of LDRs and 19.7% of DDRs experienced moderate to severe symptoms of anxiety. Similarly, 83.0% of LDRs and 72.4% of DDRs reported high levels of transplant-specific worry. Multivariate models showed younger patients expressing greater generic distress, and transplant-specific worry (P < 0.01), despite higher eGFRs (P < 0.05). ANCOVA controlling for casemix differences showed that LDRs experienced higher feelings of guilt (P = 0.004) and greater willingness to disclosure (P = 0.041). CONCLUSIONS. Clinicians should be vigilant of younger kidney transplant patients who have greater risk of poorer emotional adjustment. Future interventions should target alleviating anxiety and transplant-specific worry. Wolters Kluwer Health 2020-01-24 /pmc/articles/PMC7004627/ /pubmed/32095515 http://dx.doi.org/10.1097/TXD.0000000000000956 Text en Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Kidney Transplantation Lai, Yousheng Lester Neo, Hui Ling Michelle Vathsala, Anantharaman Griva, Konstadina Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients |
title | Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients |
title_full | Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients |
title_fullStr | Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients |
title_full_unstemmed | Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients |
title_short | Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients |
title_sort | comparing emotional adjustment of living-donor and deceased-donor kidney transplant patients |
topic | Kidney Transplantation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004627/ https://www.ncbi.nlm.nih.gov/pubmed/32095515 http://dx.doi.org/10.1097/TXD.0000000000000956 |
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