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Long JJ, Gupta N, Liu Y, Hong J, Li Y, Ali NM, Mathur A, Segev DL, McAdams-DeMarco MA. Sexual bother and sexual activity before and after kidney transplantation. Am J Transplant 2024:S1600-6135(24)00565-3. [PMID: 39299673 DOI: 10.1016/j.ajt.2024.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/16/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
Among patients awaiting kidney transplantation (KT), sexual dysfunction is common owing to end-stage kidney disease, but may improve post-KT. Leveraging a 2-center prospective study, 2422 adult KT candidates and 490 adult KT recipients (May 2014 to December 2023) were identified. Using the Kidney Disease Quality of Life Short Form, participants reported on the negative impact of sexual dysfunction due to end-stage kidney disease (ie, sexual bother) at KT evaluation, admission, and post-KT follow-ups. Using mixed-effect logistic regression models, we estimated odds and trajectories for odds of sexual bother. At evaluation, 46.1% of male and 29.6% of female candidates reported sexual bother; 39.0% and 34.5%, respectively, had been sexually active in the past 4 weeks. At admission, 53.8% male and 27.0% female recipients reported sexual bother; 41.6% and 41.8%, respectively, had been sexually active in the past 4 weeks. The estimated prevalence of sexual bother decreased during the first 3 years post-KT (odds ratio per year: 0.39; 95% CI: 0.25-0.60). Sexual activity increased and peaked 1-year post-KT. At 3 years post-KT, 48.9% of male and 50.0% of female recipients were sexually active. Sexual bother is common pre-KT and improves post-KT, and sexual activity increases post-KT. Sexual health is important and should be considered during KT management.
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Affiliation(s)
- Jane J Long
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York, USA
| | - Natasha Gupta
- Manhattan Veterans Affairs, New York, USA; Department of Urology, NYU Grossman School of Medicine and NYU Langone Health, New York, USA; Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, USA
| | - Yi Liu
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, USA
| | - Jingyao Hong
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, USA
| | - Yiting Li
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, USA
| | - Nicole M Ali
- Department of Medicine, NYU Grossman School of Medicine and NYU Langone Health, New York, USA
| | - Aarti Mathur
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dorry L Segev
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, USA.
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House TR, Marks SD, Freeman MA. Holistic care and symptom management for pediatric kidney transplant recipients. Pediatr Nephrol 2024; 39:1759-1769. [PMID: 37851087 DOI: 10.1007/s00467-023-06175-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/16/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
While many aspects of life may improve substantially for children and young people undergoing kidney transplant, there may be new challenges including symptoms that can be detrimental to health-related quality of life. Addressing symptoms requires attention to patient and family perspectives and a holistic approach grounded in symptom management. The interdisciplinary pediatric nephrology transplant team should be attuned to the prevalence of common symptoms including fatigue, anxiety, depression, post-traumatic stress, pain, and sleep disturbances, as well as poor body image and sexual health. These common symptoms require regular assessment with a focus on appropriate interventions and how care may be impacted by transplant status.
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Affiliation(s)
- Taylor R House
- Division of Nephrology, Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, 53792, USA
| | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Michael A Freeman
- Division of Pediatric Nephrology and Hypertension, Departments of Pediatrics and Humanities, Penn State College of Medicine, Penn State Health Children's Hospital, 90 Hope Drive, PO Box 855, Hershey, PA, 17036, USA.
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3
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Yoshikawa Y, Maeda K, Kosoku A, Uchida J. Male Renal Transplant Recipients' Experiences From Their Wives' Pregnancy and Childbirth. Transplant Proc 2023; 55:2046-2052. [PMID: 37783591 DOI: 10.1016/j.transproceed.2023.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/21/2023] [Indexed: 10/04/2023]
Abstract
This study aimed to analyze male renal transplant recipients' experience with their partners' pregnancy and childbirth and to investigate their methods of nursing their condition. We performed semistructured interviews and collected data from 6 Japanese males who underwent a kidney transplant after their partner had given birth. The data were analyzed using the Qualitative Synthesis Method (KJ Method). The mean age of the participants at data collection was 40.3 ± 4.7 years, whereas it was 34.7 ± 5.8 years when the transplant was performed. The Qualitative Synthesis Method revealed 7 symbols related to the pregnancy and childbirth experience of the partners of male kidney transplant recipients. Males who received a kidney transplant struggled with severe renal disease before the transplant. They also experienced indecisiveness about whether they should go through with the transplant. However, their lives changed because of the transplant and having children. This situation resulted in a sense of responsibility and a reason to live robustly for the male kidney transplant recipients. Nevertheless, they faced distress as kidney transplant patients. Their wives supported them through this experience. They communicated to their children what they learned from the experience while effectively dealing with their condition. The improvement in their sexual function resulting from the transplant influenced their determination to get married. It is necessary to offer information about the recovery of fertility and the possibility of having a child when choosing renal replacement therapy, give explanations based on evidence, and construct a counseling system.
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Affiliation(s)
- Yuki Yoshikawa
- Faculty of Nursing, Shitennoji University, Habikino, Osaka, Japan.
| | - Keiko Maeda
- Department of Nursing, Osaka Metropolitan University Hospital, Abeno-ku, Osaka-City, Japan
| | - Akihiro Kosoku
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Abeno-ku, Osaka-City, Japan
| | - Junji Uchida
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Abeno-ku, Osaka-City, Japan
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Pedreira‐Robles G, Garcimartín P, Bach‐Pascual A, Giró‐Formatger D, Redondo‐Pachón D, Morín‐Fraile V. Creating the nursing care map in the evaluation of kidney transplant candidates: A scoping review and narrative synthesis. Nurs Open 2023; 10:6668-6689. [PMID: 37480193 PMCID: PMC10495730 DOI: 10.1002/nop2.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/21/2023] [Accepted: 07/07/2023] [Indexed: 07/23/2023] Open
Abstract
AIMS To analyse the aspects involved in the care of individuals assessed as kidney transplant candidates and to identify the role of nurses in providing specialised care for this population. DESIGN Scoping review. The results were summarised using a narrative synthesis technique. DATA SOURCES A review of the literature published between 2001 and 2021 was conducted between October and November 2021 using PubMed, CINAHL and SciELO. REVIEW METHODS The research team agreed on a search strategy based on clinical practice guidelines for assessing kidney transplantation candidates. Quantitative, qualitative and mixed methods studies published in peer-reviewed journals in English, Spanish, French and Portuguese were included. RESULTS A total of 377 studies were identified, and 49 articles were included after the inclusion and exclusion criteria were applied. The narrative synthesis was structured into four themes: Physical needs; Psychological and quality of life needs; Education and adherence needs; and Nurses' role. CONCLUSION Nursing assessment of kidney transplantation candidates should encompass physical, psychosocial and adherence aspects. A variety of methodologies and resources are available for this assessment. Nurses contribute to coordinating access to kidney transplantation, aiming to improve adherence to an appropriate lifestyle to prevent patients from being excluded from kidney transplantation or suffering from kidney transplantation-related complications. IMPACT Based on our findings, we managed to design a nursing care map for kidney transplantation candidates combining the main elements of nursing care that should be incorporated into this process. Advanced practice nursing professionals play a crucial role in accessing renal transplant care.
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Affiliation(s)
- Guillermo Pedreira‐Robles
- Nephrology DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
- ESIMar (Mar Nursing School)Parc de Salut Mar, Universitat Pompeu Fabra affiliatedBarcelonaSpain
- SDHEd (Social Determinants and Health Education Research Group)IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Nursing and Health PhD ProgramUniversity of BarcelonaBarcelonaSpain
| | - Paloma Garcimartín
- Nursing DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
- Research Group in Nursing CareIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Biomedical Network Research Center for Cardiovascular DiseasesCIBERCV, Carlos III Health InstituteMadridSpain
| | - Anna Bach‐Pascual
- Nephrology DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
| | - Dolors Giró‐Formatger
- Nursing Care Methodology and Quality departmentHospital del Mar, Parc de Salut MarBarcelonaSpain
| | - Dolores Redondo‐Pachón
- Nephrology DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
- Kidney Research Group (GREN)Hospital del Mar Institute for Medical Research (IMIM), RD16/0009/0013 (ISCIII FEDER REDinREN)BarcelonaSpain
| | - Victoria Morín‐Fraile
- Department of Public Health, Mental and Maternal and Child Health, Nursing schoolUniversity of BarcelonaBarcelonaSpain
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Zahran MH, Elwasif SM, Khan I, Fakhreldin I, Elkasaby GE, El-Hefnawy AS, Osman Y, Ali-El-Dein B. The Effect of Renal Transplantation on Female Sexual Function: An Age-Matched Pair Analysis. Urology 2022; 165:164-169. [PMID: 35101547 DOI: 10.1016/j.urology.2022.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate female sexual function (FSF) after renal transplantation (RT) and compare it to an age-matched normal females (control). MATERIAL AND METHODS The study included 100 sexually active RT females in child-bearing period. Sexual function was evaluated with Female Sexual Function Index (FSFI). We compared the mean scores of all domains of FSFI to an age-matched sexually active normal females. Also, we compared the current FSFI to the pre-transplant status in 54 married females before RT. Factors affecting the FSF after RT were assessed. RESULTS In comparison to control group, RT group had statistically significant lower sexual desire (P <.001) with no significant differences as regard arousal, lubrication, orgasm, satisfaction, pain, and total FSFI score (P >.05). Among RT-females, 83% had normal sexual function, and 83.7% of the control had normal sexual function (P = .8). After RT, the FSFI score increased significantly from 20.7 ± 5.4 to 27.8 ± 3.1 (P <.001), and 85.2% had normal sexual function compared to 22.2% before RT (P <.001) with statistically significant improvement in all domains (P <.001) except for pain score (P = .8). Female circumcision was the only identified factor associated with FSD (P = .02). CONCLUSION Successful RT significantly improves female sexual function of ESRD patients. The sexual function after RT is comparable to healthy control except for lower sexual desire.
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Affiliation(s)
- Mohamed H Zahran
- Department of Urology, Urology and nephrology center, Mansoura University, Mansoura, Egypt.
| | - Salwa M Elwasif
- Department of Nephrology, Urology and nephrology center, Mansoura University, Mansoura, Egypt
| | - Imran Khan
- Department of Urology, Urology and nephrology center, Mansoura University, Mansoura, Egypt
| | - Islam Fakhreldin
- Department of Urology, Urology and nephrology center, Mansoura University, Mansoura, Egypt
| | - Ghalia E Elkasaby
- Department of Nursing, Urology and nephrology center, Mansoura University, Mansoura, Egypt
| | - Ahmed S El-Hefnawy
- Department of Urology, Urology and nephrology center, Mansoura University, Mansoura, Egypt
| | - Yasser Osman
- Department of Urology, Urology and nephrology center, Mansoura University, Mansoura, Egypt
| | - Bedeir Ali-El-Dein
- Department of Urology, Urology and nephrology center, Mansoura University, Mansoura, Egypt
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Önal B, Bender RA. Does Tacrolimus Use Have a Sexual Dysfunctional Effect in Women After Renal Transplant? Transplant Proc 2022; 54:685-689. [DOI: 10.1016/j.transproceed.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/23/2021] [Accepted: 02/01/2022] [Indexed: 11/25/2022]
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Abstract
Sexual dysfunction is defined as any abnormality in sexual arousal, libido, intercourse, orgasm, or satisfaction. It is prevalent in patients with chronic and end-stage kidney disease, with 70% to 84% of men and 30% to 60% of women reporting some form of sexual dysfunction. Although kidney transplantation improves the overall quality of life for patients receiving dialysis, it can have unexpected effects on sexual function owing to the use of immunosuppressive medications and comorbid illnesses. It is important to recognize these adverse effects and pre-emptively discuss them with patients to help mitigate consequent psychosocial discontent. Women of reproductive age will often recover fertility after kidney transplantation and therefore need to be empowered to prevent unwanted pregnancies and plan for a safe pregnancy if desired. Complications such as preeclampsia, pregnancy-induced hypertension, gestational diabetes, ectopic pregnancy, still birth, low birth weight, and preterm birth are more common in pregnant women with a kidney transplant. Careful monitoring for infection, rejection, and immunosuppressive dose adjustment along with comanagement by a high-risk obstetrician is of utmost importance. Breast-feeding is safe with most immunosuppressive medications and should be encouraged.
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Sexuality in Kidney Transplant Recipients: A Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9111432. [PMID: 34828479 PMCID: PMC8625839 DOI: 10.3390/healthcare9111432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
End-stage kidney disease has a negative impact on patients’ quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer’s hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) “The impact of a kidney transplant on sexuality”, with the subthemes “sexuality is relegated to the background”, “physical decline acts as a sexual inhibitor”, and “changes in sexual activity following a kidney transplant”; (2) “Sexual education in kidney transplant recipients” with the subthemes “sexuality: a hidden concern amongst kidney transplant recipients” and “talking about sexuality with healthcare professionals”. Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.
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9
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An Underestimated Human Need After Renal Transplantation: Sexuality. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09647-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Jabali SS, Saleem ZSM, Mohammed AA, Mahmood NM. Erectile dysfunction pre and post kidney transplant recipients in Duhok city; cross sectional study. Ann Med Surg (Lond) 2020; 55:107-110. [PMID: 32477507 PMCID: PMC7251300 DOI: 10.1016/j.amsu.2020.04.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 01/29/2023] Open
Abstract
Introduction Sexual dysfunction is a common problem in patients with chronic kidney disease. Disturbances in sexual function are noticed in early stages of chronic kidney diseases and deteriorate further as renal function declines. This is due to uremic effects, comorbid illness, anemia, hormonal disturbances, autonomic neuropathy, vascular diseases, hyperparathyroidism, hyperprolactinemia, side effects of medications, and psychosocial factors. Patients and method This is a cross-sectional study which included 59 male patients who underwent renal transplantation for more than 6 months. The International Index of Erectile Function (IIEF-5) was adopted in our study to record the erectile function. Results The mean age was 49.41 years, and the mean number of hemodialysis per month was 5.31. The cause of the chronic kidney disease was diabetes mellitus in 35.59%, glomerulonephritis in 20.34%, and hypertension in 16.95%, other causes were diagnosed in order of decreasing frequency. Most patients developed improvement in the erectile function after transplantation. There was significant correlation with 3 of the elements of the IIFE-5.i.e; penile hardness pre-penetration, Maintaining erection during intercourse, and Difficulty to maintain erection to complete the intercourse (p values 0.015, 0.011, and 0.023) respectively, and the overall improvement after transplantation which showed a p-value of less than 0.031, while there was no significant correlation with Confidence with erection and Satisfaction with intercourse before and after transplantation (p values 0.113 and 0.121) respectively. One of the patients (1.7%) developed severe dysfunction after that. Conclusion ED is common sequel of chronic kidney disease. The etiology is multifactorial and may be worsen by advanced age, presence of diabetes mellitus and prolonged duration of hemodialysis. Renal transplantation has a positive impact on sexual function and lead to improvement of erectile dysfunction. Erectile dysfunction that persists after kidney transplantation is usually attributed to multiple preexisting comorbidities. Sexual dysfunction is a common problem in patients with chronic kidney disease. The etiology of Sexual dysfunction is multifactorial. Renal transplantation has a positive impact on sexual function.
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Affiliation(s)
- Shakir Saleem Jabali
- Urologist, Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | - Zana Sidiq M Saleem
- Nephrologist, Department of Medicine, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | - Ayad Ahmad Mohammed
- General Surgeon, Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | - Newar M Mahmood
- Urologist, Duhok Directorate General of Health, Kurdistan Region, Iraq
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11
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Nikoobakht M, Behtash N, Ramezani-Binabaj M, Jelveh-Moghaddam E, Fakhr Yasseri A, Dialameh H. Comparison of sexual function changes in recipients of kidney transplant in females receiving kidney from the living donor and deceased donor. Urologia 2020; 87:203-208. [PMID: 32370652 DOI: 10.1177/0391560320913402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIM Chronic renal failure can result in different sexual and reproductive problems for women. Due to lack of information about sexual dysfunction of women with transplanted kidney and superiority of either living or deceased donor, we designed this retrospective cohort study to compare sexual function changes in recipients of kidney transplant in two groups receiving kidney from the living donor and deceased donor using Female Sexual Function Index score. METHODS AND MATERIALS We included 55 female patients who underwent kidney transplant from 22 May 2015 to 22 May 2016 in Sina Hospital (Tehran, Iran). Laboratory factors, including creatinine, blood urea nitrogen, hemoglobin, fasting blood glucose, triglyceride, cholesterol, low-density lipoprotein, and high-density lipoprotein, were evaluated before and after the transplantation. Female Sexual Function Index questionnaire was used to evaluate sexual function of the patients before the transplant, 3 months after the transplant, and 9 months after the transplant. RESULTS Our results revealed that there is significant improvement in the Female Sexual Function Index score of the patients after the transplant (p-value < .001). However, we found no significant difference between the scores of the patients with living donor and deceased donor (p-value > .05). Patients' age, creatinine level, low-density lipoprotein, and diastolic blood pressure are negative predictors of Female Sexual Function Index scores.
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Affiliation(s)
- Mohammadreza Nikoobakht
- Department of Urology, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Behtash
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Erfan Jelveh-Moghaddam
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hossein Dialameh
- Department of Urology, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sheikhalipour Z, Zamanzadeh V, Borimnejad L, Newton SE, Valizadeh L. Muslim transplant recipients' family experiences following organ transplantation. J Res Nurs 2019; 24:291-302. [PMID: 34394538 DOI: 10.1177/1744987118813671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Despite the importance of family and its relationship to positive transplant outcomes, little is known about family experiences following organ transplantation from the perspective of the transplant recipients. The literature is also devoid of information that describes the family experiences of Muslim transplant recipients. Aims The purpose of this study was to describe Muslim transplant recipients' family experiences following organ transplantation. Methods A hermeneutical phenomenological approach was employed to determine the emergent themes present in the data. The sample was composed of 12 Muslim organ transplant recipients (heart, kidney and liver) living in Iran. Semi-structured interviews were conducted with each participant. Results The primary constitutive pattern that emerged from the interview data was 'Altered Family Relationships' and three themes: fear in relationships, abnormal relationships, and the family at the centre of organ transplant issues. Conclusions There are several important findings in this study, notably that Muslim transplant recipients describe their family experiences following organ transplantation as 'altered' and not as they were pre-transplant. More research is needed that focuses on the family experience post-transplant, and how Muslim transplant recipient families are impacted by the transplant experience.
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Affiliation(s)
- Zahra Sheikhalipour
- Assistant Professor, Medical and Surgical Department, Nursing and Midwifery School, Tabriz University of Medical Sciences, Iran
| | - Vahid Zamanzadeh
- Full Professor, Medical and Surgical Department, Nursing and Midwifery School, Tabriz University of Medical Sciences, Iran
| | - Leili Borimnejad
- Full Professor, Pediatric Nursing Department, Iran University of Medical Science, Nursing Care Research Center
| | - Sarah E Newton
- Associate Professor, Oakland University School of Nursing, USA
| | - Leila Valizadeh
- Full Professor, Pediatric Nursing Department, Nursing and Midwifery School, Tabriz University of Medical Sciences, Iran
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Sexual Function, Social Isolation, Loneliness and Self-Esteem in Patients Undergoing Hemodialysis. SEXUALITY AND DISABILITY 2019. [DOI: 10.1007/s11195-019-09575-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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14
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Mota RL, Fonseca R, Santos JC, Covita AM, Marques N, Matias P, Simões H, Ramos C, Machado D, Cardoso J. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019; 16:1018-1028. [PMID: 31010779 DOI: 10.1016/j.jsxm.2019.03.266] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/10/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION 10% of the world's population suffers from chronic kidney disease. Kidney transplants provide an improvement in the quality of life of those patients. Sexual dysfunction is common after kidney transplantation, and its etiology is presumed to be multifactorial. It has a negative impact on sexual satisfaction and health-related quality-of-life. The integration of a new organ into the body can imply an adjustment of body image, which may eventually have a negative influence on intimacy and sexual behaviors. AIM To evaluate male sexual function, sexual satisfaction, and body image satisfaction among a convenience sample of patients who have had a kidney transplant. METHODS This is a cross-sectional study that included 460 patients, from a single healthcare center, who had undergone a kidney transplant procedure >4 weeks ago. A total of 112 respondents (mean = 55.5 years, SD = 11.4) answered the questionnaires properly. MAIN OUTCOME MEASURES All recruited patients answered a self-reported sociodemographic questionnaire, in addition to the International Index of Erectile function, the New Scale of Sexual Satisfaction, the Brief Symptom Inventory, and the Body Image Scale. RESULTS A correlation was found between sexual function and sexual satisfaction (r = 0.598, P < .001, n = 112), as well as between body image satisfaction and sexual function (r = -0.193, P = .042, n = 112). The length of time after a kidney transplant (≤ or >36 months) was not associated with a difference in sexual functioning or sexual satisfaction. CLINICAL IMPLICATIONS This study showed the obvious implications of sexual function on sexual satisfaction, which should alert healthcare professionals to the importance of identifying and managing sexual dysfunction in patients with chronic kidney disease, to optimize their global and sexual health satisfaction. STRENGTH & LIMITATIONS This study identified a high prevalence of sexual dysfunction among kidney transplant recipients. This should reinforce the need for the medical community to evaluate the quality-of-life domains of patients with chronic disease. There is still a lack of information concerning any longitudinal evaluation of kidney transplant patients' sexual function and the effects that this surgery has on sexuality. CONCLUSIONS This study corroborated the severe effects that kidney transplant patients often report regarding their sexuality. Among the patients who participated in the study, sexual function proved to be relevant in relation to sexual satisfaction. Mota RL, Fonseca R, Santos JC, et al. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019;16:1018-1028.
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Affiliation(s)
- Renato Lains Mota
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal.
| | - Rita Fonseca
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | - José Carlos Santos
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Ana Mateus Covita
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | | | - Patricia Matias
- Nephrology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Carnaxide, Portugal
| | - Hélder Simões
- Endocrinology Department at Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Catarina Ramos
- Instituto Universitário Egas Moniz, ISPA- Instituto Universitário; ISPA - Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Domingos Machado
- Nephrology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Carnaxide, Portugal
| | - Jorge Cardoso
- Instituto Universitário Egas Moniz, ISPA- Instituto Universitário; ISPA - Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
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Zhao L, Yan J, Yang GL, Liu Y. A Study on Adherence to Follow-up, Quality of Life, and Associated Factors Among Renal Transplant Recipients in China. Transplant Proc 2018; 49:1285-1290. [PMID: 28735995 DOI: 10.1016/j.transproceed.2017.03.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/01/2017] [Accepted: 03/15/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adherence to follow-up is vital for the medical surveillance of the postoperative blood concentration, but relatively little research has examined it, and there is less study on relationships between adherence to follow-up and quality of life (QoL). We investigated the status of adherence to follow-up and QoL and associated factors among kidney transplantation recipients in China. METHODS A cross-sectional study with the use of a Kidney Transplantation Recipient's Adherence to Follow-Up Questionnaire and a Quality of Life of Kidney Transplantation Recipients Questionnaire was conducted among 250 kidney transplantation recipients in Changsha, China, from January to March in 2015. RESULTS The mean score for adherence to follow-up was 54.71 ± 6.46. Time after transplantation was the only factor affecting adherence to follow-up scores (β = -0.210; P < .05). The mean total score for QoL was 140.39 ± 13.56; physical functioning, 23.72 ± 3.33; psychologic functioning, 24.46 ± 4.23; social functioning, 44.43 ± 6.80; treatment, 24.81 ± 2.97; and subjective satisfaction, 21.28 ± 3.15. Multiple linear regression analysis showed that adherence to follow-up, economic level, job status, donor source, and original disease affected with QoL. CONCLUSIONS Adherence to follow-up decreases with time after transplantation, and better compliance is associated with better QoL in all areas. Improvements in adherence to follow-up, income and reimbursement, psychologic guidance, and social support may increase QoL of kidney transplantat recipients.
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Affiliation(s)
- L Zhao
- Xiangya Nursing School, Central South University, Changsha, People's Republic of China; School of Nursing, University of South China, Heangyang, People's Republic of China
| | - J Yan
- Department of Nursing, Third Xiangya Hospital, Changsha, People's Republic of China
| | - G-L Yang
- Organ Transplantation Center, Third Xiangya Hospital, Changsha, People's Republic of China
| | - Y Liu
- Organ Transplantation Center, Third Xiangya Hospital, Changsha, People's Republic of China.
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van Ek GF, Keurhorst D, Krouwel EM, Nicolai MPJ, Den Ouden MEM, Elzevier HW, Putter H, Pelger RCM, Den Oudsten BL. Unravelling current sexual care in chronic kidney disease: perspective of social workers. J Ren Care 2017; 44:30-37. [PMID: 29230963 DOI: 10.1111/jorc.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers. OBJECTIVES This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice, attitude towards responsibility and knowledge of SD. DESIGN A cross-sectional study was conducted using a 41-item online survey. PARTICIPANTS Seventy-nine members of the Dutch Federation of Social Workers Nephrology. RESULTS It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p = 0.049), knowledge (p = 0.001), supplementary education (p = 0.006), and the availability of protocols on sexual care (p = 0.007). Main barriers towards discussing SD consisted of 'culture and religion' (51.9%), 'language and ethnicity' (49.4%), and 'presence of a third person' (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers. CONCLUSION This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual care.
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Affiliation(s)
- Gaby F van Ek
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Dirry Keurhorst
- Department of Social Work, Westfries Hospital, Hoorn, the Netherlands
| | - Esmée M Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Melianthe P J Nicolai
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Henk W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Rob C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Brenda L Den Oudsten
- Department of Medical and Clinical Psychology and Centre of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, the Netherlands
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17
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van Ek GF, Krouwel EM, van der Veen E, Nicolai MPJ, Ringers J, Den Oudsten BL, Putter H, Pelger RCM, Elzevier HW. The Discussion of Sexual Dysfunction Before and After Kidney Transplantation From the Perspective of the Renal Transplant Surgeon. Prog Transplant 2017; 27:354-359. [PMID: 29187127 DOI: 10.1177/1526924817731885] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Sexual dysfunction (SD) is a common problem in chronic kidney disease (CKD) and endures in 50% of patients after kidney transplantation (KTx), diminishing patients' expectations of life after KTx. Unfortunately, SD is often ignored by renal care providers. Research questions as part of a research project among all renal care providers, transplant surgeons' perspectives were obtained on sexual health care for KTx recipients, including their opinion on who should be accountable for this care. In addition, surgeons' practice and knowledge regarding SD were evaluated. DESIGN A 39-item questionnaire was sent to all Dutch surgeons and residents specialized in KTx (n = 47). RESULTS Response was 63.8%. None of the respondents discussed SD with their patients, before or after surgery. Most important barrier was that surgeons do not feel accountable for it (73.9%); 91.7% thought this accountability should lie with the nephrologist. Another barrier was insufficient knowledge (39.1%). In 75% of the respondents, (almost) no knowledge regarding SD was present and 87.5% noticed education on SD was insufficient during residence training. DISCUSSION Dutch renal transplant surgeons rarely discuss SD with their patients with CKD, as they do not feel accountable for it; this accountability was appointed to the nephrologist. Knowledge and education regarding SD were found insufficient in enabling surgeons and for some it reflects in barriers toward discussing SD. Results emphasize that accountability for providing sexual health care to patients with CKD should lie elsewhere; however, surgeons could briefly provide information on sexual health after KTx, so unfulfilled expectations may be prevented.
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Affiliation(s)
- Gaby F van Ek
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
| | - Esmée M Krouwel
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
| | - Els van der Veen
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melianthe P J Nicolai
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
| | - Jan Ringers
- 2 Department of Transplant Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda L Den Oudsten
- 3 Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, The Netherlands
| | - Hein Putter
- 4 Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob C M Pelger
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk W Elzevier
- 1 Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Medical Decision Making, Leiden University Medical Center, The Netherlands
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18
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Narasimhan E, Kennedy A, Campsen J. Transplant with a twist: A pitfall in sonographic diagnosis of renal transplant torsion. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:528-530. [PMID: 28150312 DOI: 10.1002/jcu.22439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 10/16/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Abstract
Torsion is an uncommon cause of impaired function in a renal transplant. We present a case of intraperitoneal transplant torsion secondary to adhesions to the left fallopian tube and ovary. Inability to confirm renal venous flow with Doppler misled to the erroneous sonographic diagnosis of renal vein thrombosis, although end diastolic flow was absent rather than reversed. The correct diagnosis was made with CT. The combination of abnormal orientation of the graft on ultrasonography, acutely impaired renal function, and abnormal Doppler study should have led to a diagnosis of transplant torsion. The case is also unusual in that the lead point was adnexal pathology. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:528-530, 2017.
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Affiliation(s)
- Evan Narasimhan
- Swedish Medical Center, General Surgery Residency, Seattle, WA
| | - Anne Kennedy
- Department of Radiology and Imaging Sciences, University of Utah Medical Center, Salt Lake City, UT
| | - Jeffrey Campsen
- Transplant Surgery Division, Department of Surgery, University of Utah Medical Center, Salt Lake City, UT
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Muehrer RJ, Lanuza DM, Brown RL, Djamali A. Development and Psychometric Testing of a Sexual Concerns Questionnaire for Kidney Transplant Recipients. J Nurs Meas 2015; 23:499-518. [PMID: 26673773 DOI: 10.1891/1061-3749.23.3.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE This study describes the development and psychometric testing of the Sexual Concerns Questionnaire (SCQ) in kidney transplant (KTx) recipients. METHODS Construct validity was assessed using the Kroonenberg and Lewis exploratory/confirmatory procedure and testing hypothesized relationships with established questionnaires. Configural and weak invariance were examined across gender, dialysis history, relationship status, and transplant type. Reliability was assessed with Cronbach's alpha, composite reliability, and test-retest reliability. RESULTS Factor analysis resulted in a 7-factor solution and suggests good model fit. Construct validity was also supported by the tests of hypothesized relationships. Configural and weak invariance were supported for all subgroups. Reliability of the SCQ was also supported. CONCLUSIONS Findings indicate the SCQ is a valid and reliable measure of KTx recipients' sexual concerns.
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20
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Pertuz W, Castaneda D, Rincon O, Lozano E. Sexual Dysfunction in Patients With Chronic Renal Disease: Does It Improve With Renal Transplantation? Transplant Proc 2014; 46:3021-6. [DOI: 10.1016/j.transproceed.2014.07.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Josephson MA, McKay DB. Women and transplantation: fertility, sexuality, pregnancy, contraception. Adv Chronic Kidney Dis 2013; 20:433-40. [PMID: 23978550 DOI: 10.1053/j.ackd.2013.06.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/14/2013] [Accepted: 06/17/2013] [Indexed: 01/23/2023]
Abstract
Since 1958, thousands of women with kidney transplants have become pregnant. Although most pregnancies in kidney transplant recipients are successful, they are high-risk endeavors. This seems more a function of the associated issues and comorbidities that often affect individuals with kidney transplants (eg, hypertension) or immunosuppression side effects rather than the kidney transplant per se. Regardless of the underlying pathophysiology, these pregnancies are associated with a high rate of preeclampsia diagnoses, preterm deliveries, Cesarean sections, and small-for-gestational-age babies. Given these risks, it is critical to counsel and inform transplant recipients and prospective transplant recipients of childbearing age and their partners regarding many aspects of pregnancy, including the need for contraception to prevent pregnancy after transplant, immunosuppression concerns, and the potential effect of pregnancy on the outcome of the mother, baby, and kidney transplant.
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Haspeslagh A, De Bondt K, Kuypers D, Naesens M, Breunig C, Dobbels F. Completeness and satisfaction with the education and information received by patients immediately after kidney transplant: a mixed-models study. Prog Transplant 2013; 23:12-22. [PMID: 23448815 DOI: 10.7182/pit2013249] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Self-management is important in ensuring good clinical results in kidney transplant recipients. It was unclear whether the current education program at a single kidney transplant center sufficiently prepares recent transplant recipients for the many complex self-management tasks required. OBJECTIVE To evaluate the completeness of and the satisfaction with the current inpatient kidney transplant education program and to determine recipients' needs for information in the first months after discharge. METHODS We used a concurrent mixed-methods design, including 31 kidney transplant recipients who were assessed via a semistructured interview (qualitative part) and a questionnaire specifically designed for this study, consisting of 30 Likert-type and open-ended questions (quantitative part). RESULTS Kidney transplant patients reported having received extensive information about medication use after transplant surgery (antirejection medication, 93.5%). Information about healthy lifestyle (physical activity and rehabilitation, 54.8%), return to work (54.8%), and emotional coping (25.8%) was considered suboptimal, although most patients expressed a need for such information. Patients indicated a need for more concrete and practical information, not only during their hospital stay, but also in the long term after transplant. CONCLUSIONS This is the first mixed-models approach showing that our education program immediately after transplant focuses on the transfer of factual knowledge, which seems to insufficiently train patients in developing self-management skills. Updates of our program are warranted to overcome the gaps in the information provided, to provide more practical tips, and to repeat education in the long-term after the transplant surgery, tailored to the patients' needs.
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Raggi MC, Siebert SB, Friess H, Schremmer-Danninger E, Thorban S, Dinkel A. Sexual and relationship functioning before and after renal transplantation: a descriptive study with patients and partners. ACTA ACUST UNITED AC 2012; 46:431-6. [PMID: 22725101 DOI: 10.3109/00365599.2012.693132] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Many patients experience problems with sexual functioning after renal transplantation (RTx). Research on the sexual functioning of the partners of those patients and the consequences for relationship satisfaction and quality of life is lacking. This study sought to explore changes in sexual and relationship functioning from before to after RTx in patients and their partners. MATERIAL AND METHODS Twenty-nine patients (mean ± SD age 53.4 ± 14.2 years) and 13 partners (age 57.1 ± 11.6 years) provided data 12-15 months after RTx. They retrospectively evaluated sexual and relationship functioning as well as general life satisfaction before RTx and, in comparison, in the most recent months. RESULTS Among the patients, most items on sexual experience indicated deterioration in sexual functioning. Among their partners, the wish for sexual activity with the patient and the actual frequency of sexual activity decreased from before to after RTx. The rate of partners indicating high personal importance for intercourse decreased from 83.3% to 69.2%, as did the rate of partners stating high sexual satisfaction (from 63.6% to 41.7%). Despite these trends, most patients and partners reported high relationship and life satisfaction after RTx. CONCLUSIONS Partners of patients who had received a kidney transplant seem to be affected by negative changes in the patients' sexual functioning. Nonetheless, many couples maintain high relationship and life satisfaction.
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Affiliation(s)
- Matthias Claudius Raggi
- Departments of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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