Langenbach M, Stippel A, Stippel D
Department of Psychosomatics and Psychotherapy, St Marien-Hospital Bonn, Bonn, Germany.
Transplant Proc. 2009 Jul-Aug;41(6):2512-4. doi: 10.1016/j.transproceed.2009.06.122.
The aim of this study was to investigate the quality of life of renal donors and their subjective evaluation of the donation during long-term follow-up.
We interviewed 11 donors 2 to 3 years after kidney donation. The interviews were audiotaped, transcribed, and analyzed by qualitative content analysis based on grounded theory. We grouped the resulting categories to form ideal types of subjective outcome after kidney donation.
Of the donors, 64% were female. Mean age was 40.4 years. All donors reported that they had had no medical problems after donation. Most donors experienced some form of psychological problem, such as difficulties adjusting to the new situation at home, hypochondriacal complaints and heightened awareness of bodily sensations, and fear of rejection of the recipient's kidney. Most of the donors felt their relationship to the recipient was good; some had ambivalent feelings toward the kidney recipient. Three main ideal types of donors can be differentiated: the "happy helper," the "ambivalent partner," and the "hypochondriacal complainer."
Although donors' subjective outcome after living kidney donation seems to be generally positive, it is worthwhile for the clinician to look for possible psychological problems after donation. Relating a donor to one of the described ideal types may help identify specific difficulties and guide the tailoring of individual psychological interventions. All interviewed donors wished for extended counseling after kidney donation.
本研究旨在调查肾捐赠者的生活质量及其在长期随访期间对捐赠的主观评价。
我们在肾捐赠后2至3年对11名捐赠者进行了访谈。访谈进行了录音、转录,并基于扎根理论通过定性内容分析进行了分析。我们将所得类别进行分组,以形成肾捐赠后主观结果的理想类型。
在捐赠者中,64%为女性。平均年龄为40.4岁。所有捐赠者均表示捐赠后没有出现医疗问题。大多数捐赠者经历了某种形式的心理问题,例如难以适应家庭中的新情况、疑病性主诉和对身体感觉的高度敏感,以及担心受赠者的肾脏被排斥。大多数捐赠者觉得他们与受赠者的关系良好;一些人对肾脏受赠者有矛盾的感觉。可以区分出三种主要的理想类型的捐赠者:“快乐助手”、“矛盾伙伴”和“疑病抱怨者”。
尽管活体肾捐赠后捐赠者的主观结果总体上似乎是积极的,但临床医生在捐赠后寻找可能的心理问题是值得的。将捐赠者与所描述的理想类型之一相关联可能有助于识别具体困难,并指导个性化心理干预的制定。所有接受访谈的捐赠者都希望在肾捐赠后获得延长的咨询服务。