Takada Y
Faculty of Nursing, Musashino University, Tokyo, Japan.
Transplant Proc. 2017 Jun;49(5):944-949. doi: 10.1016/j.transproceed.2017.03.023.
In 2013, a total of 1586 kidney transplants were performed in Japan, and 1431 (90.2%) of the organs were from living donors. The purpose of this study is to illuminate the awareness of living kidney donors toward kidney donation after the condition of the recipient changed, thus clarifying the influence of that recognition on the donor.
This study design was qualitative descriptive research. Transplant coordinators at 4 hospitals were commissioned to screen subject candidates and hand-deliver printed research explanations to them. Candidates who responded were selected as subjects. I conducted semistructured interviews and analyzed them using the grounded theory approach. This research was approved by the Ethics Research Committee, Faculty of Nursing, Toho University.
The survey period was from April to November 2014, and consent was obtained from 5 donors and 5 recipients. The outcome of recipients who received kidneys from the 5 donors was as follows: recovered after temporary worsening (n = 3), early graft loss (n = 1), and early death (n = 1). The core category was "to the donor, the meaning of kidney donation is continually redefined." The donors had a strong interest in the physical condition of the recipient. The 3 changes in the recipients' physical condition, defined as "recovery," "temporary worsening," and "complete deterioration," affected the donor's condition.
Due to changes in the recipient's physical condition, donors' psychological and physical condition and their definition of the meaning of kidney donation also changed. Health care systems that guarantee lifelong follow-up of the physical and psychological condition of donors after donation are needed.
2013年,日本共进行了1586例肾移植手术,其中1431例(90.2%)的器官来自活体供者。本研究的目的是阐明活体肾供者在受者病情发生变化后对肾脏捐献的认知,从而明确这种认知对供者的影响。
本研究设计为定性描述性研究。委托4家医院的移植协调员筛选研究对象候选人,并将印刷好的研究说明亲手交给他们。回复的候选人被选为研究对象。我进行了半结构化访谈,并采用扎根理论方法对访谈进行分析。本研究得到了东邦大学护理学院伦理研究委员会的批准。
调查期为2014年4月至11月,获得了5名供者和5名受者的同意。接受这5名供者肾脏的受者的结果如下:暂时恶化后恢复(n = 3)、早期移植肾失功(n = 1)和早期死亡(n = 1)。核心类别是“对供者来说,肾脏捐献的意义在不断重新定义”。供者对受者的身体状况非常关注。受者身体状况的3种变化,即“恢复”“暂时恶化”和“完全恶化”,影响了供者的状况。
由于受者身体状况的变化,供者的心理和身体状况以及他们对肾脏捐献意义的定义也发生了变化。需要建立医疗保健系统,以保证对供者捐献后身体和心理状况进行终身随访。