Transplant Recipient's Knowledge of Posttransplant Malignancy Risk: Implications for Educational Programs

An integrative literature review of kidney transplantation knowledge tools

PURPOSE

This study aimed to identify knowledge measurement tools for kidney transplantation (KT) and confirm their assessment methods, domains, and validity to provide useful information.

DESIGN

An integrative review based on Whittemore and Knafl's (2005) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines.

METHODS

An integrative search was conducted using four English databases (PubMed, Embase, CINAHL, and the Cochrane Library) and the top three Korean databases (RISS, DBpia, and KISS). Search terms and strategies included ("kidney transplant*" OR "renal transplant*" OR "kidney replace*" OR "renal replace*" OR "kidney graft" OR "renal graft") & (knowledge OR awareness) & (scale OR tool OR instrument OR questionnaire OR inventory). The time limit was set to February 2022. The extracted data included the content of the tools, participants, and psychometrics. Quality of life was assessed using a psychometric grading framework.

RESULTS

A total of 15 studies and 13 tools were reviewed. Of these, seven studies (46.7%) targeted KT patients, five (33.3%) targeted KT candidates, and three (20.0%) included both groups. The number of items in the tools ranged from five to 33 items. Furthermore, seven tools comprised true-false questions and eight multiple-choice questions. The domains of the KT knowledge measurement tool used in each study differed across study participants. Both reliability and validity were confirmed in six tools, and only two showed a grade of "adequate" or higher.

CONCLUSION

A validated tool is required to measure KT knowledge. These tools can be used to evaluate the effectiveness of educational interventions in promoting self-management after KT.

PROTOCOL REGISTRATION NUMBER

CRD42022334559.

A Mixed-Method Study to Explore Patients' Perspective of Self-Management Tasks in the Early Phase after Kidney Transplant

Context

Patients' perspectives of posttransplant self-management tasks have not been explored.

Objective

To explore the concept and the presence of self-management tasks mastered by patients in the early phase after kidney transplant.

Design

Mixed-method study using semistructured interviews and a structured questionnaire.

Setting

Outpatient Division of Nephrology at University Hospital Zurich, Switzerland

Patients

Twelve patients (median age, 52 years, interquartile range, 42.25–65.25 years; median time after kidney transplant, 6.5 months; interquartile range, 2.25–15.75 months) were included.

Analysis

Qualitative data were analyzed according to Corbin and Strauss' 3 self-management tasks with content analysis procedures. In the quantitative analysis, the presence of each self-management task is expressed as a frequency.

Results

The qualitative findings showed that patients were greatly challenged by the effort to manage the upcoming instability, which has a persistent broad impact on their lives. Managing emotions comprised dealing with uncertainty, disappointment, and frustration. Additionally, patients had to manage changes in self-perception. Managing life roles mainly involved an adaptation of relationships, occupational changes, and interactions with health care providers. Taking medications, managing symptoms, integrating new behaviors, and understanding one's course of disease were further tasks. Quantitatively, self-management tasks that were perceived as a challenge by at least half of the patients were primarily tasks from the questionnaire section “managing stressful emotions and self-perception.” The synthesis of qualitative and quantitative findings indicates that self-management programs for kidney transplant recipients should focus on strengthening patients' self-management of emotional tasks and on regaining stability in daily life.

The start of the transplant journey: referral for pediatric solid organ transplantation

The focus of the majority of the psychosocial transplant literature is on post-transplant outcomes, but the transplant journey starts much earlier than this, at the point when transplantation is first considered and a referral for transplant evaluation is made. In this review, we cover information regarding the meaning of the referral process for solid organ transplantation. We discuss various factors of the referral for transplantation including the impact of referral on the pediatric patient and the family, potential expectations and misconceptions held by pediatric patients and parents, the role of health literacy, decision-making factors, and the informational needs of pediatric patients and parents. We elucidate steps that providers can take to enhance transplant referral and provide suggestions for much needed research within this area.

Nursing care of the pancreas transplant recipient

Pancreas transplantation has been successful for restoring euglycemia in persons with type 1 diabetes mellitus. The transplantation may be performed as a single procedure, or it may follow or be performed simultaneous with kidney transplantation. This article discusses potential consequences of hyperglycemia and hypoglycemia and indications, alternatives, and contraindications for transplantation. The author also describes postoperative nursing care and potential complications including surgical and immunologic. Potential outcomes of pancreas transplantation can include survival benefit, physiologic improvement, and enhanced quality of life.