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Biswas T, Mishra S, Mishra BR. Psychological graft-rejection: A need to understand the construct in transplant scenarios. Asian J Psychiatr 2023; 85:103625. [PMID: 37216794 DOI: 10.1016/j.ajp.2023.103625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Tathagata Biswas
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Sayali Mishra
- Department of Clinical Psychology, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India
| | - Biswa Ranjan Mishra
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
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Rodger D, Cooper DKC. Kidney xenotransplantation: Future clinical reality or science fiction? Nurs Health Sci 2023; 25:161-170. [PMID: 36335558 PMCID: PMC10124775 DOI: 10.1111/nhs.12994] [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: 08/20/2022] [Revised: 10/10/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
There is a global shortage of organs for transplantation and despite many governments making significant changes to their organ donation systems, there are not enough kidneys available to meet the demand. This has led scientists and clinicians to explore alternative means of meeting this organ shortfall. One of the alternatives to human organ transplantation is xenotransplantation, which is the transplantation of organs, tissues, or cells between different species. The resurgence of interest in xenotransplantation and recent scientific breakthroughs suggest that genetically engineered pigs may soon present a realistic alternative as sources of kidneys for clinical transplantation. It is therefore important for healthcare professionals to understand what is involved in xenotransplantation and its future implications for their clinical practices. First, we explore the insufficiency of different organ donation systems to meet the kidney shortage. Second, we provide a background and a summary of the progress made so far in xenotransplantation research. Third, we discuss some of the scientific, technological, ethical, and public health issues associated with xenotransplantation. Finally, we summarize the literature on the attitudes of healthcare professionals toward xenotransplantation.
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Affiliation(s)
- Daniel Rodger
- Institute of Health and Social Care, School of Allied and Community Health, London South Bank University, London, UK
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - David K. C. Cooper
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
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Psychosocial Characteristics of Patients Evaluated for Kidney, Liver, or Heart Transplantation. Psychosom Med 2023; 85:98-105. [PMID: 36201770 DOI: 10.1097/psy.0000000000001142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Psychosocial parameters play a pivotal role in organ recipient evaluation before wait-listing for transplantation because of their impact on organ and patient outcome. Patients in need of heart (HTx), liver (LTx), or kidney transplantation (KTx) face distinct physical and psychological challenges. This study compares the psychosocial characteristics and preferences for additional therapy for patients undergoing assessment for these three types of organ transplantation to optimize patient-tailored psychological, social, and other supportive interventions. METHODS We conducted a cross-sectional, observational study with 1110 potential transplantation candidates (LTx, n = 544; KTx, n = 330; HTx, n = 236), psychosocial status was determined for depressive symptoms (Patient Health Questionnaire Depression Scale), anxiety symptoms (seven-item Generalized Anxiety Disorder Screener), health-related quality of life (36-Item Short Form Health Survey), perceived social support (Perceived Social Support Questionnaire), sense of coherence (SoC; short form of the Sense of Coherence Scale), self-efficacy (General Self-Efficacy Short Scale), and body image (German Body Image Questionnaire-20). Preferences for additional supportive therapy were assessed dichotomously. Data were analyzed using multivariate analysis of covariance and χ2 tests. RESULTS Patient groups differed significantly regarding depression ( F (2,1107) = 35.283, p < .001, partial η2 = 0.01), anxiety ( F (2,1107) = 15.027, p < .001, partial η2 = 0.03), health-related quality of life (physical: F (2,1107) = 96.772, p < .001, partial η2 = 0.15; mental: F (2,1107) = 11.442, p < .001, partial η2 = 0.02), perceived social support ( F (2,1107) = 20.813, p < .001, partial η2 = 0.04), SoC ( F (2,1107) = 12.920, p < .001, partial η2 = 0.02), self-efficacy ( F (2,1107) = 17.308, p < .001, partial η2 = 0.03), and body image (rejecting body evaluation: F (2,1107) = 5.006, p = .007, partial η2 = 0.01; vital body dynamics: F (2,1107) = 40.216, p < .001, partial η2 = 0.07). Patients evaluated for HTx showed the highest psychosocial impairment and the highest inclination regarding additional supportive therapy. CONCLUSIONS Patients evaluated for HTx, LTx, and KTx have distinct psychosocial characteristics and treatment preferences. HTx patients display the highest psychosocial impairment. We suggest psychocardiological treatment structures for optimal outcome.
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Jang H, Im HY, Nam HJ. The life experiences of living liver donors: A qualitative meta‐synthesis. Res Nurs Health 2022; 45:693-706. [DOI: 10.1002/nur.22273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/26/2022] [Accepted: 09/04/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Hye‐Young Jang
- College of Nursing, Hanyang University Seoul South Korea
| | - Hyei Yeon Im
- College of Nursing, Hanyang University Seoul South Korea
| | - Hye Jin Nam
- College of Nursing, Seoul National University Seoul South Korea
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Understanding the role of scars in adults' narratives of childhood liver transplantation: A sociological perspective. Soc Sci Med 2022; 294:114709. [PMID: 35030395 DOI: 10.1016/j.socscimed.2022.114709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/16/2021] [Accepted: 01/08/2022] [Indexed: 11/21/2022]
Abstract
For sociological and anthropological scholars alike, the body is both a physical and social entity as well as a project to be worked on by the self and by others (Tamari, 2020). However, scholars' conceptual work in organ transplantation and the body has tended to overlook the resultant surgical scars, yet these are borne by all transplantation recipients. For example, in understanding biomedicine's intervention in the body through the skin Shildrick (2008) uses the term 'corporeal cut' conceptually rather than focus on the flesh that is cut and the scar that subsequently forms. In this way body flesh has become abstract; cut but unmarked, with transplantation scars being an 'absent presence' in these disciplines' thinking. In this paper we attempt to develop a more nuanced understanding of how organ transplantation shapes both the corporeality of the body and the embodiment of the self through considering the concept of a transplant scar in three ways. First, through transplantation scars' dynamic physical appearance across their lifecourse and their symbolic meaning for their bearer. Second, how scars' coded messages are framed for 'stranger' audiences in the context of their little experience of organ transplantation; and third, through the scars' display and storytelling in the context of more intimate relationships. Interview data from 27 adult survivors of childhood liver transplantation, who bear either 'Lexus' or 'Mercedes' transplantation scars, are drawn upon to illustrate these concepts. Awareness of the meanings associated with the scar as well as others' reactions, imputed or not, to the physicality of the scar point to the significance of the body as a corporeal marker of personal narratives and negotiations. It also indicates the polysemic nature of the scarring and the way in which inventive narratives can play a positive as well as negative role in the lives of organ transplant recipients.
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Hennemann K, Bauer-Hohmann M, Klewitz F, Tegtbur U, Pape L, Schiffer L, Schiffer M, de Zwaan M, Nöhre M. Organ integration in kidney transplant patients - Results of a KTx360° substudy. J Psychosom Res 2021; 145:110464. [PMID: 33814191 DOI: 10.1016/j.jpsychores.2021.110464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/15/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Organ transplantation is the treatment of choice for patients with end-stage organ disease. From early on, the psychological perspective on integrating the organ has been of interest. As quantitative studies on organ integration are scarce, we aimed at evaluating this aspect in a large sample of kidney transplant (KTx) recipients. METHODS For this cross-sectional study, 684 patients after KTx were recruited within the structured post-transplant care program KTx360°. To measure organ integration and donor relationship, a previously developed and published questionnaire (FOSP), generated explicitly for this purpose, was used. Associations with sociodemographic, medical, donation-specific, and psychological variables were investigated. RESULTS Overall, more than 90% of the patients perceived the transplant as part of themselves; however, a small minority reported perceiving it as a foreign object. Frequent thoughts about the donor and the belief of having adopted some of the donor's traits were common (52% and 14%, respectively), specifically in living donor recipients. Higher anxiety and depression scores and reduced kidney functioning were associated with less ideal organ integration, while a more extended period since KTx and more perceived social support correlated with better organ integration. No association between organ integration and adherence, as well as organ integration and cognitive functioning, could be found. CONCLUSION Organ integration and donor relationship were unproblematic in most KTx patients. However, offering psychosocial support to those struggling with organ integration and donor relationship is crucial from a clinical perspective.
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Affiliation(s)
- Khira Hennemann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Maximilian Bauer-Hohmann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Felix Klewitz
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Uwe Tegtbur
- Department of Sports Medicine, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Lars Pape
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany; Department of Pediatrics II, University Hospital Essen, Essen, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Lena Schiffer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Mario Schiffer
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany; Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany.
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Experiencing one's own body and body image in living kidney donors-A sociological and psychological study. PLoS One 2021; 16:e0249397. [PMID: 33857150 PMCID: PMC8049271 DOI: 10.1371/journal.pone.0249397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 03/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of the study was to perform an in-depth exploratory analysis of the experience and image of one's body among living kidney donors. METHOD The research was carried out using mixed methodology. The study on experiencing one's own body was carried out using the sociological methodology of the grounded theory (qualitative research). This method was supplemented with psychometric measurement-the Body Esteem Scale (quantitative research). The basic research method was the in-depth interview. Using this method, a group of 25 living kidney donors who had not experienced any serious health or psychological problems after donation was examined. The participants of the study came from three transplant centers in Poland. RESULTS The data from the sociological interviews indicate that the donors: 1. do not experience radical changes in the functioning of their body; 2. maintain full control over it and do not feel the absence of a kidney in the body; 3. consciously and reflectively take care of their body after donation. In addition, the sociological research indicates that caring for one's own body also includes the transferred organ. The kidney donors experience a kind of bodily identity extension, including the recipient's body. However, the personal and social identity of the studied kidney donors is not disturbed in any way. The psychometric data correspond to the sociological results and indicate: 1. a lack of extreme emotional assessments about one's body; 2. awareness of one's own body and consistency of its image; 3. reduced emotional assessment of body zones directly related to the surgery; 4. differences in body image between the sexes. CONCLUSIONS The research results presented in the text indicate not only the possibility, but also the need for triangulation of research methods in the study of the experience and image of one's own body in living kidney donors. The proposed research approach employing mixed methodology within the fields of sociology and psychology for researching the phenomenon of living kidney donation is not very common.
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Järvholm S, Enskog A, Hammarling C, Dahm-Kähler P, Brännström M. Uterus transplantation: joys and frustrations of becoming a ‘complete’ woman—a qualitative study regarding self-image in the 5-year period after transplantation. Hum Reprod 2020; 35:1855-1863. [DOI: 10.1093/humrep/deaa143] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 05/06/2020] [Indexed: 12/28/2022] Open
Abstract
Abstract
STUDY QUESTION
How is a women’s self-image affected by uterus transplantation (UTx)?
SUMMARY ANSWER
Women experienced receiving a uterus in both positive and negative ways, but in general, their self-image was positively affected; regardless of whether they have given birth to a child or not, recipients describe themselves as being ‘back to normal’ after the hysterectomy to remove the transplanted uterus.
WHAT IS KNOWN ALREADY
UTx has repeatedly proved to be a successful treatment for absolute uterine factor infertility. However, there has been no previous qualitative long-term research into the self-image of women undergoing UTx.
STUDY DESIGN, SIZE, DURATION
This complete, prospective cohort study included the nine recipients of the first UTxs performed in Sweden mostly in 2013. Interviews took place in the 5 years following surgery.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Eight out of the nine recipients had congenital absence of the uterus, a characteristic of Mayer–Rokitansky–Küster–Hauser syndrome, and one recipient lacked a uterus after a radical hysterectomy due to cervical cancer. The mean age of participants was 31.5 years at inclusion and at this time they all lived in stable marital relationships. Post-transplantation, interviews were performed annually for 5 years, comprising a total of 43 interviews. The interview followed a semi-structured guide. All interviews (median duration of around 25 minutes) were recorded, transcribed verbatim and then analysed by thematic approach.
MAIN RESULTS AND THE ROLE OF CHANCE
The joys and frustrations of becoming a ‘complete’ woman are seen as a master theme, which influences the three underlying subthemes, a changed self-perception, a changed body and a changed sexuality. Each of these subthemes have three underlying categories.
LIMITATIONS, REASONS FOR CAUTION
The small sample size is a limitation.
WIDER IMPLICATIONS OF THE FINDINGS
The results provide information that will be helpful in pre-operative screening procedures and in the psychological support offered both to women who experienced successful and unsuccessful outcomes following UTx.
STUDY FUNDING/COMPETING INTEREST(S)
Funding was received from the Jane and Dan Olsson Foundation for Science; the Knut and Alice Wallenberg Foundation; an ALF grant from the Swedish state under an agreement between the government and the county councils; the Swedish Research Council; a Ferring Pharmaceuticals scholarship in memory of Robert Edwards; and the Iris Jonzén-Sandblom and Greta Jonzén Foundation. The authors have no competing interests.
TRIAL REGISTRATION NUMBER
NCT01844362.
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Affiliation(s)
- Stina Järvholm
- Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Enskog
- Department of Anesthesia and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Catrina Hammarling
- Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pernilla Dahm-Kähler
- Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Brännström
- Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Stockholm IVF-EUGIN, Stockholm, Sweden
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Pedreira Robles G, Aguayo-González MP. From physical to emotional pain in chronic kidney disease: Nurses' perceptions. J Ren Care 2019; 45:212-222. [PMID: 31622026 DOI: 10.1111/jorc.12302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Changes in body image are a recurring theme in the literature on chronic kidney disease (CKD). There is insufficient evidence identifying nurses' perceptions of this topic. OBJECTIVE To explore nurses' perceptions of changes in the bodies of persons with CKD. DESIGN Phenomenological study. METHODS Data were collected by semi-structured interviews with nephrology nurses selected through pragmatic sampling until data saturation. The interviews were transcribed and analyzed using the seven phases of Colazzi. FINDINGS Information saturation was achieved with six nurses. Coexisting elements were found between the physical and emotional impact of CKD, and therefore the data were organised into a central theme: "From physical to emotional pain in the individual's body". This central theme was defined by seven subthemes that describe the coexistence of these two physical and emotional spheres, giving rise to the appearance of important meanings in the changes occurring in the bodies of individuals diagnosed with CKD. These meanings included stigma, dysfunctionality, emotional pain, the feeling of slavery, lack of information, taboo and hope. CONCLUSIONS In the nurses' perspective, the changes occurring in the bodies of people with CKD can transcend the physical sphere and acquire more complex meanings. Nurses have a unique insight into these complex meanings, which include all the domains of the person, and which have important implications for daily practice. IMPLICATIONS FOR PRACTIC Nurses should have specialised training in providing effective responses to patients' emotional needs. It is also important to incorporate professional profiles that support nursing interventions.
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De Pasquale C, Pistorio ML, Veroux M, Sciacca F, Martinelli V, Carbonaro A, Giaquinta A, Carbone F, Palermo C, Veroux P. Nonverbal Communication and Psychopathology in Kidney Transplant Recipients. Transplant Proc 2019; 51:2931-2935. [PMID: 31607624 DOI: 10.1016/j.transproceed.2019.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/23/2019] [Accepted: 05/13/2019] [Indexed: 02/06/2023]
Abstract
Transplant recipients have difficulty expressing, identifying, and describing their emotional experiences. The Machover human figure test allows us to bring out the deepest contents of a patient's personality, which are normally hidden and not explained to structured quantitative tests. The study analyzed possible situations of distress and possible symptoms of psychopathology in kidney transplant recipients, emerged from the projective test of the human figure and not easily verbalized to the common standardized tests. The sample included 80 kidney transplant patients (51 men and 29 women; mean age, 47.74 [SD, 12.39] years) during follow-up visits at 12 months after transplant. The Machover test was used to evaluate body image, affective aspects, and personality variables by projective method; the Symptom Checklist-90-R was used for the evaluation of possible psychopathology, and the 36-Item Short Form Health Survey was used for the assessment of perceived quality of life. RESULTS: showed that the more anxiety there is in the human figure test, the less somatization dimensions (ANX/SOM R = -331, P < .05), depression (ANX/DEP R = -326, P < .05), and the global index of psychic symptomatology (ANX/GSI R = -367, P < .05) of the Symptom Checklist-90-R are present. This research has confirmed the hypothesis that the spontaneous graphic production of the recipients, through the projective methods, allows them to identify and deepen their psychological contents and to activate and maintain a good psychophysical balance post transplant.
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Affiliation(s)
- Concetta De Pasquale
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University Hospital of Catania, Catania, Italy; Department of Formative Science, University of Catania, Catania, Italy.
| | - Maria Luisa Pistorio
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University Hospital of Catania, Catania, Italy
| | - Massimiliano Veroux
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University Hospital of Catania, Catania, Italy
| | - Federica Sciacca
- Department of Formative Science, University of Catania, Catania, Italy
| | | | - Anna Carbonaro
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University Hospital of Catania, Catania, Italy
| | - Alessia Giaquinta
- Department of Medical and Surgical Sciences, University of Catania, Catania, Italy
| | - Fausto Carbone
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University Hospital of Catania, Catania, Italy
| | - Chiara Palermo
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University Hospital of Catania, Catania, Italy
| | - Pierfrancesco Veroux
- Department of Medical and Surgical Sciences, University of Catania, Catania, Italy
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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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Rodrigue JR, Schold JD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Fleishman A, Pavlakis M, Mandelbrot DA. Mood, body image, fear of kidney failure, life satisfaction, and decisional stability following living kidney donation: Findings from the KDOC study. Am J Transplant 2018; 18:1397-1407. [PMID: 29206349 PMCID: PMC5988866 DOI: 10.1111/ajt.14618] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/25/2023]
Abstract
Prior studies demonstrate that most living kidney donors (LKDs) report no adverse psychosocial outcomes; however, changes in psychosocial functioning at the individual donor level have not been routinely captured. We studied psychosocial outcomes predonation and at 1, 6, 12, and 24 months postdonation in 193 LKDs and 20 healthy controls (HCs). There was minimal to no mood disturbance, body image concerns, fear of kidney failure, or life dissatisfaction, indicating no incremental changes in these outcomes over time and no significant differences between LKDs and HCs. The incidence of any new-onset adverse outcomes postdonation was as follows: mood disturbance (16%), fear of kidney failure (21%), body image concerns (13%), and life dissatisfaction (10%). Multivariable analyses demonstrated that LKDs with more mood disturbance symptoms, higher anxiety about future kidney health, low body image, and low life satisfaction prior to surgery were at highest risk of these same outcomes postdonation. It is important to note that some LKDs showed improvement in psychosocial functioning from pre- to postdonation. Findings support the balanced presentation of psychosocial risks to potential donors as well as the development of a donor registry to capture psychosocial outcomes beyond the mandatory 2-year follow-up period in the United States.
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Affiliation(s)
- JR Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - JD Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - LK Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Department of Medicine, University of Arizona, Tucson, AZ,School for the Science of Health Care Delivery, Arizona State University, Phoenix, AZ
| | - A Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - M Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - DA Mandelbrot
- Department of Medicine, University of Wisconsin, Madison, WI
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13
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Pérez-San-Gregorio MÁ, Martín-Rodríguez A, Borda-Mas M, Avargues-Navarro ML, Pérez-Bernal J, Gómez-Bravo MÁ. Coping Strategies in Liver Transplant Recipients and Caregivers According to Patient Posttraumatic Growth. Front Psychol 2017; 8:18. [PMID: 28163691 PMCID: PMC5247441 DOI: 10.3389/fpsyg.2017.00018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 01/04/2017] [Indexed: 01/10/2023] Open
Abstract
The purpose of this study was to analyze the differences in coping strategies employed by liver transplant recipients and their family members according to patient posttraumatic growth. Two matched groups of 214 liver transplant recipients and 214 family members were selected. The Posttraumatic Growth Inventory and Brief COPE were used. The most relevant results were: (1) Interactive effects in active coping, support (instrumental and emotional) and acceptance strategies, which were all used more by patients with higher growth levels, while their family members showed no differences in use of these strategies by patient growth level. Furthermore, while a low level of patient growth did not mark differences between them and their caregivers, a high level did, patients employing more active coping and support (instrumental and emotional), (2) In both groups a high level of patient growth was associated with more use of positive reframing and denial than a low one, and (3) Self-blame was employed by patients more than by their caregivers. It was concluded that a high level of posttraumatic growth in liver transplant recipients is associated with more use of healthy coping strategies, basically active coping, instrumental support, and emotional support.
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Affiliation(s)
- M. Ángeles Pérez-San-Gregorio
- Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of SevilleSeville, Spain
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of SevilleSeville, Spain
| | - Mercedes Borda-Mas
- Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of SevilleSeville, Spain
| | - M. Luisa Avargues-Navarro
- Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of SevilleSeville, Spain
| | - José Pérez-Bernal
- Critical Care and Urgencies, University Hospital Virgen del Rocío of SevilleSeville, Spain
| | - M. Ángel Gómez-Bravo
- Hepatic-Biliary-Pancreatic Surgery and Liver Transplant Unit, University Hospital Virgen del Rocío of SevilleSeville, Spain
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14
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Sadeghian J, Roudsari DM, Seyedfatemi N, Rafiei H. Body-Image Disturbance: A Comparative Study among Haemodialysis and Kidney Transplant Patients. J Clin Diagn Res 2016; 10:OC14-6. [PMID: 27437264 DOI: 10.7860/jcdr/2016/15699.7733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/16/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION As a chronic disease, End Stage Renal Disease (ESRD) changes the patients' body and affects their body image negatively. Although the changes in body image are expected in all types of renal replacement therapies, different renal replacement therapy methods could represent different levels of impact on body image. AIM Present study was conducted to examine and compare the level of body-image disturbance between haemodialysis and kidney transplant patients. MATERIALS AND METHODS This descriptive study was conducted in two teaching hospitals in Tehran, Iran. Using convenient sampling, 84 patients (42 patients under haemodialysis and 42 patients with transplant) were invited to participate in the study. A self-designed questionnaire was developed to examine the level of body-image disturbance. RESULTS Out of 42 haemodialysis patients, 64.3%, 19% and 16.7% of patients reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 21.1±18.3(rang=1-71) in haemodialysis patients. Of 42 transplant patients, 69%, 26.2% and 4.8% reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 17.1±13.3 (rang=1-48). According to the results of independent t-test, difference between mean score of body-image disturbance in two groups was statistically significant (p < 0.05). CONCLUSION The findings of the present study showed that both haemodialysis and renal transplant patients experienced some levels of body-image disturbance. This problem was more prevalent among haemodialysis patients as compared to kidney transplant ones. We recommend more studies may be conducted in this regard.
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Affiliation(s)
- Jaleh Sadeghian
- Hemodialysis Center, Alzahra Hospital, Isfahan University of Medical Science , Isfahan, Iran
| | - Daryadokht Masroor Roudsari
- Medical Surgical Department, Nursing and Midwifery School, Iran University of Medical Science , Tehran, Iran
| | - Naeimeh Seyedfatemi
- Medical Surgical Department, Nursing and Midwifery School, Iran University of Medical Science , Tehran, Iran
| | - Hossein Rafiei
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences , Qazvin, Iran; Medical Surgical Department, Nursing and Midwifery School, Qazvin University of Medical Science, Qazvin, Iran
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