Oguten Evrim Gode, Barlas Ilhami Soykan, Akin Emin Barıs
Department of Psychiatry, School of Medicine, Demiroglu Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey.
Department of General Surgery, School of Medicine, Demiroglu Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2232-2236. doi: 10.1016/j.transproceed.2019.01.154. Epub 2019 Aug 6.
The aims of this study were to (1) determine psychological states and wellbeing of living kidney donors and (2) assess their interaction and association with subjective evaluations of donors. This retrospective, cross-sectional study was conducted with 208 living kidney donors (123 women; 59.1%), aged between 22 and 79 years (48.74 ± 11.78) who underwent a nephrectomy between 2006 and 2017. All donors were evaluated face-to-face. The sociodemographic data collection form, a 4-question survey developed by researchers for subjective evaluations, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and Contentment with Life Assessment Scale (CLAS) were administered. Only few donors, 3.8% and 7.2% respectively, were above the clinical cut off scores of the BDI and BAI. This was equivalent to the normal population. Eighty percent of respondents were satisfied with life. Only 5 donors (2.4%) claimed to have any regrets about their experience and scored higher for depression and lower for life satisfaction (P < .001). Similarly, 33 (15.9%) donors having thoughts of getting ill easily after the operation were found to be more depressive and anxious, with lower life satisfaction (P < .001). In most cases their relationship to the recipient was reported not to be changed (64.4%) or even improved (32.5%), and that was found to be related to lower depression scores (P < .001). Respondents within the first year of donation reported higher depression (P = .019) and lower life satisfaction (P = .001) scores. Finally, postoperative complications were found to increase anxiety and lower life satisfaction (P = .018, P = .026). Degree of affinity between donors and recipients showed no difference in postoperative psychological outcomes and life satisfaction. These results suggest that overall, living kidney donation does not have a negative impact on donors' life satisfaction and mental status in the long term. However, the results of the unvalidated additional survey questions underlined the importance of follow-up of donors, especially in the first year, and screening of donors' subjective experiences in gaining additional insight about donors' mental well-being.
（1）确定活体肾供者的心理状态和幸福感；（2）评估他们与供者主观评价之间的相互作用和关联。这项回顾性横断面研究对208名活体肾供者（123名女性，占59.1%）进行，年龄在22至79岁之间（48.74±11.78），于2006年至2017年期间接受了肾切除术。所有供者均接受了面对面评估。采用了社会人口学数据收集表、研究人员编制的用于主观评价的4个问题调查问卷、贝克抑郁量表（BDI）、贝克焦虑量表（BAI）和生活满意度评估量表（CLAS）。只有少数供者（分别为3.8%和7.2%）高于BDI和BAI的临床临界分数。这与正常人群相当。80%的受访者对生活感到满意。只有5名供者（2.4%）表示对自己的经历有任何遗憾，且抑郁得分较高，生活满意度得分较低（P<0.001）。同样，33名（15.9%）供者在术后容易产生生病的想法，被发现更抑郁、焦虑，生活满意度较低（P<0.001）。在大多数情况下，他们与受者的关系报告未发生变化（64.4%）甚至有所改善（32.5%），且这与较低的抑郁得分相关（P<0.001）。捐赠后第一年的受访者抑郁得分较高（P=0.019），生活满意度得分较低（P=0.001）。最后，发现术后并发症会增加焦虑并降低生活满意度（P=0.018，P=0.026）。供者与受者之间的亲和程度在术后心理结果和生活满意度方面没有差异。这些结果表明，总体而言，活体肾捐赠从长期来看对供者的生活满意度和心理状态没有负面影响。然而，未经验证的额外调查问卷结果强调了对供者进行随访的重要性，尤其是在第一年，以及筛查供者的主观经历对于深入了解供者心理健康的重要性。
