Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients.

Autor:	Lai YL; Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Imperial College and Nanyang Technological University, Singapore., Neo HLM; Department of Psychological Medicine, National University Hospital, Singapore., Vathsala A; National University Centre for Organ Transplantation, National University Hospital, Singapore., Griva K; Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Imperial College and Nanyang Technological University, Singapore.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2020 Jan 24; Vol. 6 (2), pp. e529. Date of Electronic Publication: 2020 Jan 24 (Print Publication: 2020).
DOI:	10.1097/TXD.0000000000000956
Abstrakt:	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. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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