Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
BMJ Open. 2018 Jun 22;8(6):e021275. doi: 10.1136/bmjopen-2017-021275.
The aim was to study the expectations of improvement in life and health following kidney transplantation (KTx) in a population of wait-listed patients ≥65 years with end-stage kidney disease.
Qualitative research with individual in-depth interviews.
Patients on dialysis enlisted for a KTx from a deceased donor were included from an ongoing study of older patients' perspectives on KTx. Qualitative face-to-face interviews were conducted in a safe and familiar setting, and were analysed thematically using the theoretical framework of lifespan.
Fifteen patients (median age 70 years, range 65-82) from all parts of Norway were interviewed. Informants were included consecutively until no new information was gained.
Two main themes were evident: receiving a kidney is getting life back and grasp the chance. In addition, the themes 'hard to loose capacity and strength', 'reduced freedom' and 'life on hold' described the actual situation and thereby illuminated the informants' expectations. The informants tried to balance positive expectations and realism towards KTx, and they were hoping to become free from dialysis and to live a normal life.
This study shows that older KTx candidates comprise a heterogeneous group of patients who take individual approaches that allow them to maintain autonomy and control while waiting for a transplant. This study provides new knowledge about the older KTx candidates relevant for clinicians, patients and researchers.
本研究旨在探讨≥65 岁终末期肾病等待肾移植(KTx)患者对生活和健康改善的期望。
定性研究,采用个体深入访谈。
从一项关于老年患者对 KTx 看法的正在进行的研究中,纳入正在接受透析并等待来自已故供体的 KTx 的患者。在安全且熟悉的环境中进行面对面的定性访谈,并使用寿命理论框架进行主题分析。
来自挪威各地的 15 名患者(中位年龄 70 岁,范围 65-82 岁)接受了采访。连续纳入受访者,直到没有新信息获得为止。
有两个主要主题很明显:接受肾脏移植就是找回生活和抓住机会。此外,“难以失去能力和力量”、“自由受限”和“生活暂停”这三个主题描述了实际情况,从而阐明了受访者的期望。受访者试图平衡对 KTx 的积极期望和现实,他们希望摆脱透析并过上正常的生活。
本研究表明,老年 KTx 候选者是一组异质性患者,他们采取个体化的方法,在等待移植的过程中保持自主性和控制感。本研究为临床医生、患者和研究人员提供了有关老年 KTx 候选者的新知识。