Institute of Applied Health Research, University of Birmingham, Birmingham, UK
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
BMJ Open. 2020 Mar 31;10(3):e035627. doi: 10.1136/bmjopen-2019-035627.
To explore why transplant patients experience unexpected mild-to-moderate distress and what support they may need.
Qualitative study using individual in-depth interviews.
Four National Health Service (NHS) Trusts in the Midlands, UK.
Fifteen renal transplant patients meeting the criteria for mild-to-moderate distress from their responses to emotion thermometers.
Identification of the reasons for distress and support options acceptable to renal transplant patients.
Three themes were interpreted from the data: 'I am living with a "foreign body" inside me', 'why am I distressed?' and 'different patients want different support'. Following their transplant, participants felt that they should be happy and content, but this was often not the case. They described a range of feelings about their transplant, such as uncertainty about the lifespan of their new kidney, fear of transplant failure or fear of the donor having health conditions that may transfer to them. A few experienced survivors' guilt when others they had met at the dialysis unit had not received a transplant or because someone had died to enable them to receive the transplant. No longer having regular contact with the renal unit made participants feel isolated. Some participants did not initially attribute the source of their distress to their transplant. Participants' preferred support for their distress and their preferences about who should deliver it varied from peer support to seeing a psychologist.
Raising the issue of post-transplant mild-to-moderate distress with patients and encouraging them to think about and plan coping strategies pretransplant may prove beneficial for the patient and healthcare provider. Patients should be able to choose from a variety of support options.
探讨移植患者经历意外的轻度至中度痛苦的原因，以及他们可能需要哪些支持。
采用个体深入访谈的定性研究。
英国中部的四个国民保健服务（NHS）信托。
15 名符合轻度至中度痛苦标准的肾移植患者，根据情绪温度计的反应得出。
确定痛苦的原因和肾移植患者可接受的支持选项。
从数据中解读出三个主题：“我身体里有一个‘异物’”、“我为什么痛苦？”和“不同的患者需要不同的支持”。移植后，参与者感到他们应该快乐和满足，但情况往往并非如此。他们描述了一系列对移植的感受，例如对新肾脏寿命的不确定性、对移植失败的恐惧或对供体可能将健康状况转移给他们的恐惧。少数人在遇到透析病房的其他人没有接受移植或有人因接受移植而死亡时，会感到幸存者的内疚。不再与肾脏科保持定期联系，使参与者感到孤立。一些参与者最初并没有将他们痛苦的根源归因于移植。参与者对其痛苦的首选支持以及他们对谁应该提供支持的偏好，从同伴支持到看心理学家，各不相同。
与患者一起提出移植后轻度至中度痛苦的问题，并鼓励他们在移植前思考和规划应对策略，这对患者和医疗保健提供者都可能有益。患者应该能够从各种支持选项中进行选择。
