Psychosocial and Ethical Behaviors and Attitudes of Health Care Professionals in the Clinical Setting of Living Kidney Donors: A Qualitative Study

Arai, Nana; Takimoto, Yoshiyuki; Nakazawa, Eisuke; Ishimura, Takeshi; Yokoyama, Naoki; Hara, Mayumi; Ozeki-Hayashi, Reina; Akabayashi, Akira

doi:10.1016/j.transproceed.2022.04.026

Cited by 3 publications

(6 citation statements)

References 23 publications

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“…FAD = family assessment device. (the patient; Arai et al, 2022), from the perspective of donor protection (The Japan Society for Transplantation, 2021a), both parties must be treated as independent entities. Many studies have reported a good postoperative relationship in LRKT (Nöhre et al, 2018;Ralph et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…This suggests the need for understanding and support from the perspectives of both donors and recipients. In Japan, LRKT is based on the decision of the entire family (Arai et al, 2022). Therefore, it is important to understand how donors and recipients perceive the family.…”

Section: Discussionmentioning

confidence: 99%

“…This study revealed that family functioning before transplantation is not always consistent between donors and recipients. Although healthcare providers tend to focus on the recipient (the patient; Arai et al, 2022), from the perspective of donor protection (The Japan Society for Transplantation, 2021a), both parties must be treated as independent entities. Many studies have reported a good postoperative relationship in LRKT (Nöhre et al, 2018; Ralph et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…A study from China noted that mental health was poorer among parent donors than sibling donors (Chen et al, 2015). A Japanese report stated that in spousal LRKT from wife to husband, the husband is expected to carry the financial burden after LRKT (Arai et al, 2022); however, another report indicated that spousal LRKT strengthens the bond between the recipient and donor (Watanabe & Hiraga, 2002). In a meta-summary of published studies, the authors noted that it remains unclear what relationships (e.g., siblings, parents, and children) influence decision-making (Ummel et al, 2011).…”

Section: Public Significance Statementmentioning

confidence: 99%

“…Healthcare providers tend to focus on KT treatment in patients with chronic kidney disease (i.e., the recipient) and could not sufficiently focus on the donor (Arai et al, 2022). However, donors are also the families of chronically ill patients who experience time, psychological, and material burdens (Ghasemi et al, 2020).…”

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confidence: 99%

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Family functioning before kidney transplantation from living-related donors: Perspectives of donors and recipients in Japan.

Kamba,

Kobayashi,

Akaho

et al. 2024

Families, Systems, & Health

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In Japan, approximately 90% of kidney transplantations involve living donors who are relatives. Selection of a living donor from potential family member donors could affect the entire family. However, reports focusing on preliving-related kidney transplant (LRKT) family functioning are lacking. Family functioning comprises ways that family members communicate and cooperate with each other. The Family Assessment Device (FAD) was used to measure family functioning from the perspective of donors and recipients just prior to LRKT. Method: A total of 122 donor-recipient pairs (244 participants in total) who planned to have LRKT were recruited consecutively from July 2020 to July 2021 and included in the analysis. Results: There was no significant difference in FAD scores between donors and recipients, with approximately 20% of both groups reporting poor family functioning. Differences in family functioning according to types of relatives were shown in recipients. The rate of poor family functioning was significantly lower in the spouse group than in the parent-to-child group (recipient: 6.6%, 29.3%; donor: 8.2%, 34.1%, respectively). However, agreement regarding good or poor family functioning assessment was high in the parent-to-child pairs and low in the spouse pairs. Discussion: Most LRKT donors and recipients reported good family functioning; however, some perceived poor family functioning. Evaluations by donors did not always align with that of recipients, especially among spouse pairs. It is important to treat them as independent entities. Preoperative assessment to connect them with appropriate support can enhance recovery after LRKT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Public Significance Statementmentioning

confidence: 99%

mentioning

confidence: 99%

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Family functioning before kidney transplantation from living-related donors: Perspectives of donors and recipients in Japan.

Kamba,

Kobayashi,

Akaho

et al. 2024

Families, Systems, & Health

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Perceptions of Psychosocial and Ethical Issues and the Psychological Characteristics of Donors in the Clinical Setting of Living Kidney Donors: A Qualitative Study

Arai

Yokoyama

Hara

et al. 2023

AJOB Empirical Bioethics

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Non-Maleficence toward Young Kidney Donors: A Call for Stronger Ethical Standards and Associated Factors in Multidisciplinary Nephrology Teams

Tarabeih,

Na’amnih

2024

Nursing Reports

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Background: The rising frequency of live kidney donations is accompanied by growing ethical concerns as to donor autonomy, the comprehensiveness of disclosure, and donors’ understanding of long-term consequences. Aim: To explore donors’ satisfaction with the ethical competence of multi-professional nephrology teams regarding disclosure of donation consequences to live kidney donors. Methods: A cross-sectional study was performed among Israeli live kidney donors who had donated a kidney in two hospitals that belonged to the Ministry of Health’s Transplantation Center one year after the donation, from December 2018 to December 2020. Data collection was conducted online and through face-to-face interviews with the donors in their native language (Hebrew or Arabic). Results: Overall, 91 live kidney donors aged 18–49 years were enrolled. Of those, 65.9% were males, and 54.9% were academic donors. Among the live kidney donors, 59.3% reported that the motivation behind the donation was a first-degree family member vs. 35.2% altruistic and 5.5% commercial. Only 13.2% reported that the provided disclosure adequately explained the possible consequences of living with a single kidney. Approximately 20% of the participants reported that the disclosure included information regarding their risk of developing ESRD, hypertension, and proteinuria. The donors reported a low mean of the index score that indicates a low follow-up by the physician after the donation (mean = 1.16, SD = 0.37). The mean GFR level was significantly lower in the post-donation period one year following a kidney donation (117.8 mL/min/1.73 m2) compared with the pre-donation period (84.0 mL/min/1.73 m2), p < 0.001. Conclusion: Our findings display that donors’ satisfaction with the ethical competence of multi-professional nephrology teams regarding the disclosure of donation consequences to live kidney donors is low. This study indicates that donors are at an increased risk of worsening kidney functions (creatinine and GFR), and BMI. Our findings underscore the imperative to advise donors that their condition may worsen over time and can result in complications; thus, they should be monitored during short and long-term follow-up periods. This study was not registered.

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Psychosocial and Ethical Behaviors and Attitudes of Health Care Professionals in the Clinical Setting of Living Kidney Donors: A Qualitative Study

Cited by 3 publications

References 23 publications

Family functioning before kidney transplantation from living-related donors: Perspectives of donors and recipients in Japan.

Family functioning before kidney transplantation from living-related donors: Perspectives of donors and recipients in Japan.

Perceptions of Psychosocial and Ethical Issues and the Psychological Characteristics of Donors in the Clinical Setting of Living Kidney Donors: A Qualitative Study

Non-Maleficence toward Young Kidney Donors: A Call for Stronger Ethical Standards and Associated Factors in Multidisciplinary Nephrology Teams

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