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Title: The study of living kidney donor decision-making and psychosocial outcomes
Author: McNeill, Yvonne L.
ISNI:       0000 0004 2736 5288
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2011
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Background: Individuals with end-stage kidney disease need dialysis or a kidney transplant. Kidney transplantation from a living donor is the preferred treatment. Live kidney donor transplantation, however, is an invasive surgery performed on a healthy individual for the benefit of another person. Therefore, donors should be fully informed of the risks involved in donation. The medical outcomes for kidney donors are well known, however, the research investigating the psychosocial impact of donation is limited. Understanding the psychosocial outcome of living kidney donation would promote informed consent, allow donors to plan their postoperative recovery period, and guide the development of services that maintain the long-term health of donors. Aims: This study aimed to investigate the postoperative quality of life of live kidney donors, to investigate which variables predict postoperative psychosocial outcome, with particular interest in the variable of coping style and to gather information regarding how individuals decide to become living kidney donors and how satisfied they are with their pre- and postoperative care. Methods: Living kidney donors at Glasgow Western Infirmary, Manchester Royal Infirmary and St. James’ Hospital, Leeds were asked to complete a preoperative assessment consisting of the SF-36, HADS, COPE and The Donor Decision Control Scale. Four weeks postoperative, donors were asked to again complete these questionnaires, and in addition The Living Donor Survey. Results: -­‐ 48 -­‐ Complete data was available for thirteen donors. The results indicate that live kidney donation had a significant adverse affect on the physical wellbeing of the donors; the postoperative scores on the PCS and all of the corresponding domains were significantly lower and with a large effect size. Five (38%) of the donors experienced postoperative complications, three of whom were readmitted to hospital. With respect to psychological wellbeing, donors’ scores on the MCS did not differ significantly from their preoperative scores. With respect to anxiety, for the group as a whole, postoperative HADS anxiety scores were lower and the severity and prevalence of anxiety symptoms reduced. For depression there was only a marginal increase in HADS depression scores. Analysis of each individual’s outcomes indicated that there was a marked difference in the impact of donation. The results suggest that poor psychosocial outcome following donation was marginally associated with relying on mental disengagement as a coping strategy. Improved outcome in the postoperative period was associated with seeking social support Conclusions: The physical health of donors is adversely affected by live kidney donation. Four weeks postoperatively live kidney donors report their physical health as being worse than those with long-standing illness. The psychological wellbeing of the majority of donors appears to be largely unaffected by live kidney donation. However, a minority of donors report a poorer psychological wellbeing following donation. Individuals who use active coping strategies have higher postoperative MCS scores, reflecting better psychological wellbeing. However, this conclusion should be interpreted with caution due the small sample size and therefore the possibility of a type I error.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: R Medicine (General) ; BF Psychology