Liu Kuan-Lin, Wang Hsu-Han, Hsieh Chin-Yi, Chen Lee-Chuan, Lin Kuo-Jen, Lin Chih-Te, Chien Ching-Hui
Department of Surgery, Division of Urology, Chang Gung Memorial Hospital at Keelung, Keelung City, Taiwan.
School of Medicine, Chang Gung University, Tao-Yuan City, Taiwan.
Res Nurs Health. 2025 Jun;48(3):337-348. doi: 10.1002/nur.22451. Epub 2025 Feb 1.
Previous research indicates that most living kidney donors (LKDs) are content with their decision to donate and seldom experience regret. Nevertheless, a small percentage of donors report adverse experiences, such as psychological distress and reduced vitality. Therefore, it is essential to explore the experiences of LKDs, particularly within the context of their decision-making process both before and following kidney donation. This study aimed to examine the decisional conflict and decisional regret experienced by LKDs from the evaluation stage to 12 months post-donation and to identify the associated factors. A longitudinal study design was implemented, and the initial data collection took place when potential LKDs visited the hospital for evaluation (n = 50). Subsequent data collection was conducted at 3 (n = 49), 6, and 12 (n = 46) months post-donation. Variables, including basic demographics, decisional conflict, decisional regret, perceived control, psychological distress, and healthcare orientation, were collected. Generalized estimating equations were used to obtain inferential statistics. Results showed that perceived control characterized by personal control orientation, lower psychological distress, and better healthcare orientation were associated with reduced decisional conflict among LKDs. Meanwhile, lower decisional regret was associated with better self-perceived health status, perceived control inclined toward interpersonal control, and less psychological distress among LKDs. Nurses should assess the decisional conflict and mental health of potential LKDs, and provide clear information to support their decision regarding kidney donation. They should also offer self-care information and stress-coping strategies related to living donor nephrectomy to aid in reducing decisional conflict and regret.
先前的研究表明，大多数活体肾供者（LKDs）对自己的捐赠决定感到满意，很少感到后悔。然而，一小部分供者报告了不良经历，如心理困扰和活力下降。因此，探索活体肾供者的经历至关重要，尤其是在他们肾捐赠前后的决策过程背景下。本研究旨在调查活体肾供者从评估阶段到捐赠后12个月所经历的决策冲突和决策后悔，并确定相关因素。实施了一项纵向研究设计，初始数据收集在潜在活体肾供者到医院进行评估时进行（n = 50）。后续数据收集在捐赠后3个月（n = 49）、6个月和12个月（n = 46）进行。收集了包括基本人口统计学、决策冲突、决策后悔、感知控制、心理困扰和医疗保健取向等变量。使用广义估计方程来获得推断统计量。结果表明，以个人控制取向为特征的感知控制、较低的心理困扰和较好的医疗保健取向与活体肾供者决策冲突的减少有关。同时，较低的决策后悔与较好的自我感知健康状况、倾向于人际控制的感知控制以及活体肾供者较少的心理困扰有关。护士应评估潜在活体肾供者的决策冲突和心理健康，并提供清晰的信息以支持他们关于肾捐赠的决定。他们还应提供与活体供肾切除术相关的自我护理信息和压力应对策略，以帮助减少决策冲突和后悔。
