Adolescente renal crónico: alteraciones físicas, sociales y emocionales pos-trasplante

Abstract

RESUMENLa experiencia del trasplante renal en la adolescencia produce una sensación de incertidumbre del pronóstico, pero también de esperanza y de fe de encontrar estímulos para vencer los obstáculos. Realizado en el ambulatorio de trasplante renal de un hospital público es un estudio cualitativo, descriptivo cuyo objetivo es conocer las alteraciones físicas, sociales y emocionales en la vida del adolescente pos-trasplante renal. Doce adolescentes contestaron a las preguntas de una entrevista estructurada. Los resultados muestran que las limitaciones físicas más significativas fueron el alejamiento escolar, restricciones en la vida social y dificultad en practicar ejercicio. En relación a las alteraciones sociales, el ocio y la frecuencia escolar eran menores en los tres primeros meses pos-trasplante, período considerado más vulnerable. El apoyo de la familia y de los amigos fue el punto de soporte emocional identificado por los entrevistados. Los adolescentes adquirieron nuevas cualidades psicológicas para superar los obstáculos surgidos después lo trasplante. PALABRAS CLAVE:TRASPLANTE RENAL ADOLESCENTE CONDUCTA DE SALUD CHRONIC ADOLESCENT RENAL PATIENTS: PHYSICAL, SOCIAL AND EMOTIONAL POST-TRANSPLANT ALTERATIONS SUMMARYUndergoing a kidney transplant in adolescence produces a feeling of uncertainty as to the prognosis, but also of hope and trust in finding stimuli to overcome obstacles. Conducted in the kidney transplant centre of a public hospital, it is a qualitative, descriptive study the aim of which is to determine the physical, social and emotional alterations in the life of a post-kidney transplant adolescent. Twelve adolescents replied to the questions in a structured interview. The results show that the most significant physical limitations were being away from school, restrictions in social life and difficulty in getting exercise. In relation to social alterations, leisure and going to school were lower in the first three months after the transplant, the period considered the most vulnerable. The support of family and friends was the point of emotional support identified by interviewees. Adolescents acquired new psychological qualities to overcome the obstacles arising after the transplant. KEY WORDS: RENAL TRANSPLANT ADOLESCENT HEALTH BEHAVIOUR 12 Rev Soc Esp Enferm Nefrol 2005; 8 (4): 260/264

Psychosocial impact of pediatric living-donor kidney and liver transplantation on recipients, donors, and the family: a systematic review

“…In one study, 73% of recipients were at least to some extent willing to discuss their medical condition among peers . Although one study concluded that health status seldom or never interfered with social life , others reported some social life restrictions, for instance withdrawal from peers or having to leave parties earlier .…”

“…Most recipients were satisfied with life (58–66%) , experienced no emotional restrictions (67%) , and did not characterize themselves as being ill (47–67%) . In one study, recipients experienced increased self‐esteem and a renewed ability to cope with physical, emotional and social stress . However, unfavorable impacts were also reported, including feelings of shame and a fragile body image , worries about the future (87%), and feelings of ‘being different’ (53%) .…”

“…In one study, recipients experienced increased self-esteem and a renewed ability to cope with physical, emotional and social stress [27]. However, unfavorable impacts were also reported, including feelings of shame and a fragile body image [27,28], worries about the future (87%), and feelings of 'being different' (53%) [26]. In three studies, emotional difficulties and distress in recipients were related to feelings of guilt toward the donor [28][29][30].…”

“…Diagnosis of mental health disorders [22][23][24] Frequency of use of psychiatric services [24] Self-report of psychiatric symptoms [25,33] Emotional and behavioral well-being (n = 6): Ability to deal with adolescent development tasks [28,30] Body image [26,27] Coping ability [27] Emotional quality of life [27,29] Experience of restrictions in life [26] Feelings of being different [26] Identity of being ill [25,26] Worries about the future [26] Social functioning (n = 5): Interference of health with social life [25,27,28] Openness about health condition towards others [26] Frequency of social contacts [25,29] Quality of social relationships [25,28] Satisfaction with peer support [27]…”

“…Although one study concluded that health status seldom or never interfered with social life [25], others reported some social life restrictions, for instance withdrawal from peers [28] or having to leave parties earlier [27].…”