Liu Dian, Xu Huilan, Zhang Zhihao, Wang Liang, Liu Jia, Zhu Xiao
Third Xiangya Hospital, Central South University, Changsha 410013.
Xiangya School of Public Health, Central South University, Changsha 410013.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2025 May 28;50(5):888-896. doi: 10.11817/j.issn.1672-7347.2025.240554.
End stage renal disease (ESRD) is a major disease that seriously threatens the health of young people, and kidney transplantation is an effective treatment method to improve its prognosis.Young ESRD patients at a critical stage of life development often face significant physical and psychological challenges while waiting for kidney transplantation. Their psychological state directly affects treatment compliance and transplantation outcomes.This study aims to explore the psychological experiences of young patients with end stage renal disease during the waiting period for kidney transplantation, and provide a reference for formulating relevant psychological intervention measures.
A descriptive qualitative research design was adopted. Using purposive sampling, 20 young ESRD patients awaiting for kidney transplantation at the Transplantation Center of Xiangya Third Hospital, Central South University, from June to August 2024, were recruited. Based on the socio-ecological systems theory, a semi-structured interview outline was developed, and directed content analysis was applied to analyze the interview data.
According to the results of qualitative interviews, 3 themes and 9 sub-themes were summarized as follows: Microsystem (disease pain experience, anxiety during transplantation waiting period, cognitive differentiation and coping differences), mesosystem (imbalance of family roles and dependent guilt, physician-patient trust dynamics, ambivalence toward peer support), and macrosystem (decision-making powerlessness caused by information asymmetry, sociocultural stigma and public bias, institutional dependence and passive behavior).
Young ESRD patients experience complex psychological experiences during the waiting period for kidney transplantation. Healthcare providers should explore corresponding intervention measures based on patients' psychological status to improve their waiting period experience and promote both physical and mental health.
终末期肾病（ESRD）是严重威胁年轻人健康的重大疾病，肾移植是改善其预后的有效治疗方法。处于生命发展关键阶段的年轻ESRD患者在等待肾移植期间往往面临重大的身心挑战。他们的心理状态直接影响治疗依从性和移植结果。本研究旨在探讨年轻终末期肾病患者在等待肾移植期间的心理体验，为制定相关心理干预措施提供参考。
采用描述性定性研究设计。采用目的抽样法，招募了20名于2024年6月至8月在中南大学湘雅三医院移植中心等待肾移植的年轻ESRD患者。基于社会生态系统理论，制定了半结构化访谈提纲，并应用定向内容分析法对访谈数据进行分析。
根据定性访谈结果，总结出3个主题和9个子主题如下：微观系统（疾病疼痛体验、移植等待期焦虑、认知分化与应对差异）、中观系统（家庭角色失衡与依赖内疚、医患信任动态、对同伴支持的矛盾态度）和宏观系统（信息不对称导致的决策无力感、社会文化耻辱感与公众偏见、机构依赖与被动行为）。
年轻ESRD患者在等待肾移植期间经历复杂的心理体验。医护人员应根据患者心理状况探索相应干预措施，以改善其等待期体验，促进身心健康。
