University of South Australia Cancer Research Institute, Adelaide, SA, Australia.
Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia.
Aust J Rural Health. 2021 Feb;29(1):92-105. doi: 10.1111/ajr.12693. Epub 2021 Feb 7.
There is no evidence that being a rural or regional organ transplant recipient has adverse physical health outcomes post-surgery compared with those experienced by people living in cities, but the impact of living remotely from transplant centres on psychosocial outcomes has not been explored.
To identify the social, emotional, psychological, spiritual, informational and practical issues associated with being a regionally based organ transplant recipient or carer and determine how support services could be improved for this group.
DESIGN/ SETTING/ PARTICIPANTS: Twenty-two purposively sampled adult Australians who lived outside metropolitan centres and had received an organ transplant (n = 15) or were the primary carer of someone who had received one (n = 7), participated in semi-structured, telephone interviews. Qualitative data were collected until data saturation was reached and were analysed using thematic analysis.
Five key themes (plus subthemes) were identified: (a) travelling for specialist transplant care takes a toll, (b) unique transplant-related psychological and emotional issues experienced before and after transplants, (c) caring for transplant recipients is a demanding role, (d) lay, peer and professional support, including rural general practitioners and accommodation facilities, help ease the burden, but (e) significant barriers to accessing transplant-focused psychosocial support exist.
Novel methods of delivering targeted, transplant-specific information and psychosocial care to rural transplant recipients and their carers, employers and rural health professionals require development and evaluation. Strategies might be delivered by peers or professionals via telehealth, telephone, social media or websites for example, depending on preferences and level of need.
目前尚无证据表明，与居住在城市的人相比，农村或地区器官移植受者在手术后的身体健康结果更差，但居住在远离移植中心的偏远地区对心理社会结果的影响尚未得到探讨。
确定与作为地区性器官移植受者或照顾者相关的社会、情感、心理、精神、信息和实际问题，并确定如何为这一群体改善支持服务。
设计/环境/参与者：22 名来自澳大利亚农村地区的成年人，他们居住在大都市中心以外的地方，并接受了器官移植（n=15）或作为接受过器官移植的人的主要照顾者（n=7），参加了半结构式电话访谈。收集定性数据，直到达到数据饱和，并使用主题分析进行分析。
确定了五个关键主题（加子主题）：（a）为接受专科移植护理而旅行会造成损失，（b）移植前后经历的独特移植相关心理和情绪问题，（c）照顾移植受者是一项艰巨的任务，（d）非专业、同行和专业支持，包括农村全科医生和住宿设施，有助于减轻负担，但（e）存在获得移植为重点的心理社会支持的重大障碍。
需要开发和评估向农村移植受者及其照顾者、雇主和农村卫生专业人员提供有针对性的、特定于移植的信息和心理社会护理的新方法。例如，根据偏好和需求程度，策略可以由同行或专业人员通过远程医疗、电话、社交媒体或网站等方式提供。
