Dew Mary Amanda, Zuckoff Allan, DiMartini Andrea F, DeVito Dabbs Annette J, McNulty Mary L, Fox Kristen R, Switzer Galen E, Humar Abhinav, Tan Henkie P
University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Prog Transplant. 2012 Sep;22(3):280-92; quiz 293. doi: 10.7182/pit2012890.
Although some living donors experience psychological, somatic, and interpersonal difficulties after donation, interventions to prevent such outcomes have not been developed or evaluated.
To (1) summarize empirical evidence on psychosocial outcomes after donation, (2) describe a theoretical framework to guide development of an intervention to prevent poor outcomes, and (3) describe development and initial evaluation of feasibility and acceptability of the intervention.
Based on a narrative literature review suggesting that individuals ambivalent about donation are at risk for poor psychosocial outcomes after donation, the intervention targeted this risk factor. Intervention structure and content drew on motivational interviewing principles in order to assist prospective donors to resolve ambivalence. Data were collected on donors' characteristics at our institution to determine whether they constituted a representative population in which to evaluate the intervention. Study participants were then recruited to assess the feasibility and acceptability of the intervention. They were required to have scores greater than 0 on the Simmons Ambivalence Scale (indicating at least some ambivalence about donation).
Our population was similar to the national living donor population on most demographic and donation-related characteristics. Eight individuals who had been approved to donate either a kidney or liver segment were enrolled for pilot testing of the intervention. All successfully completed the 2-session telephone-based intervention before scheduled donation surgery. Participants' ratings of acceptability and satisfaction were high. Open-ended comments indicated that the intervention addressed participants' thoughts and concerns about the decision to donate.
The intervention is feasible, acceptable, and appears relevant to donor concerns. A clinical trial to evaluate the efficacy of the intervention is warranted.
尽管一些活体捐赠者在捐赠后会经历心理、身体和人际关系方面的困难，但尚未开发或评估用于预防此类结果的干预措施。
（1）总结关于捐赠后心理社会结果的实证证据；（2）描述一个理论框架，以指导预防不良结果的干预措施的开发；（3）描述该干预措施的开发以及对其可行性和可接受性的初步评估。
基于一项叙述性文献综述表明，对捐赠存在矛盾心理的个体在捐赠后有出现不良心理社会结果的风险，该干预措施针对这一风险因素。干预结构和内容借鉴了动机性访谈原则，以帮助潜在捐赠者解决矛盾心理。收集了我们机构捐赠者的特征数据，以确定他们是否构成一个有代表性的群体来评估该干预措施。然后招募研究参与者来评估该干预措施的可行性和可接受性。他们在西蒙斯矛盾心理量表上的得分需大于0（表明至少对捐赠有一定的矛盾心理）。
在大多数人口统计学和与捐赠相关的特征方面，我们的群体与全国活体捐赠者群体相似。八名已被批准捐赠肾脏或肝段的个体被纳入该干预措施的试点测试。所有人都在预定的捐赠手术前成功完成了为期两阶段的电话干预。参与者对可接受性和满意度的评分很高。开放式评论表明，该干预措施解决了参与者对捐赠决定的想法和担忧。
该干预措施是可行的、可接受的，并且似乎与捐赠者的担忧相关。有必要进行一项临床试验来评估该干预措施的疗效。
