The psychosocial needs of adolescent and young adult kidney transplant recipients, and associated interventions: a scoping review

Wurm, Fina; McKeaveney, Clare; Corr, Michael; Wilson, Anna; Noble, Helen

doi:10.1186/s40359-022-00893-7

Cited by 12 publications

(12 citation statements)

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“…The psychosocial adaption of kidney transplant recipients is a dynamic process impacted by a variety of factors and is closely related to quality of life (Pasquale, 2014;Kamran and Ogden, 2016). According to Wurm et al (2022), kidney transplant recipients have adverse psychosocial experiences after surgery and often have more unmet needs related to equality in healthcare, acceptance, and negative emotion. Indeed, prior research found that the prevalence of anxiety ranged from 25 to 50% among kidney transplant recipients (Fanakidou et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China

Wang

Chang

2023

Front. Psychol.

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BackgroundNo research has yet been done on social support’s influence on the association between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China. Accordingly, it remains unclear how medical personnel can assist patients in successfully adjusting to the early postoperative period and improving their health.ObjectiveThis study sought to explore the influence of illness perception and social support on the psychosocial adaptation of young and middle-aged recipients of kidney transplants in China during the early postoperative period.MethodsThis study adopted a cross-sectional design. The study included 236 young and middle-aged kidney transplant recipients from a tertiary hospital in China. Demographic and disease-related data were collected. Additionally, the Psychosocial Adjustment to Illness Scale-Self-Report, the Brief Illness Perception Questionnaire, and the Multidimensional Scale of Perceived Social Support were used to assess participants’ psychosocial adaptation, illness perception, and social support, respectively. The model was examined using descriptive analysis, Pearson’s correlation analysis, hierarchical multiple regression analysis, and the PROCESS Macro in SPSS 26.0.ResultsA total of 176 (74.56%) participants reported an average psychosocial adaptation score >50, which is relatively negative. Marital status, education level, residence, per capita monthly income (in Chinese yuan), medical insurance, work status, post-transplant time, body mass index, creatinine status, and complications were all related to psychosocial adaptation (p < 0.05). The more negative their illness perception and the worse their social support, the worse the psychosocial adaptation of young and middle-aged kidney transplant recipients. Further, the effect of illness perception on psychosocial adaptation was partially mediated by social support (36.56%).ConclusionIn general, the psychosocial adaption level of young and middle-aged kidney transplant recipients was negative during the early postoperative period. Healthcare teams should assist patients in building a positive illness perception shortly following kidney transplantation, while also providing psychological care and support to help them cope with the onset of psychosocial issues.

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Section: Introductionmentioning

confidence: 99%

Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China

Wang

Chang

2023

Front. Psychol.

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“…Third, Medicare data do not contain psychosocial variables indicative of transplant appropriateness (eg, Stanford Integrated Psychosocial Assessment for Transplant ) and likelihood of postoperative care adherence. Future studies are needed to determine how to best evaluate psychosocial factors linked with transplant outcomes in adults with IDD and the effect of readiness for a transplant, available support systems, and other psychosocial factors on rates of transplant among this population. Fourth, examining postoperative adequacy of care and treatment adherence was beyond the scope of this study, but is an important consideration for future work.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, we could not control for this in our analysis or examine the extent to which differences in donor type may have affected our findings. Third, Medicare data do not contain psychosocial variables indicative of transplant appropriateness (eg, Stanford Integrated Psychosocial Assessment for Transplant) and likelihood of postoperative care adherence . Future studies are needed to determine how to best evaluate psychosocial factors linked with transplant outcomes in adults with IDD and the effect of readiness for a transplant, available support systems, and other psychosocial factors on rates of transplant among this population.…”

Section: Discussionmentioning

confidence: 99%

Comparing Kidney Transplant Rates and Outcomes Among Adults With and Without Intellectual and Developmental Disabilities

et al. 2023

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ImportanceImproving equity in organ transplant access for people with intellectual and developmental disabilities (IDD) is a topic of social discourse in mainstream media, state legislation, and national legislation. However, few studies have compared evaluation rates, transplant rates, and outcomes among adults with and without IDD.ObjectiveTo compare rates of kidney transplant and transplant-specific outcomes between propensity–score matched groups of adults with end-stage kidney disease (ESKD [also referred to as end-stage renal disease (ESRD)]) with and without co-occurring IDD.Design, Setting, and ParticipantsThis retrospective cohort study included all Medicare inpatient and outpatient standard analytical files from 2013 through 2020. A total of 1 413 655 adult Medicare beneficiaries with ESKD were identified. Propensity–score matching was used to balance cohorts based on age, sex, race, follow-up duration, and Charlson Comorbidity Index. The matched cohorts consisted of 21 384 adults with ESKD (10 692 of whom had IDD) and 1258 kidney transplant recipients (629 of whom had IDD). Data were analyzed between June 1, 2022, and August 1, 2022.ExposureIDD.Main Outcomes and MeasuresEvaluation for kidney transplant, receipt of kidney transplant, perioperative complications, readmission, mortality, graft rejection, and graft failure.ResultsOf the 21 384 propensity–score matched adults with ESKD, the median (IQR) age was 55 (43-65) years, 39.2% were male, 27.4% were Black, 64.1% were White, and 8.5% identified as another race or ethnicity. After propensity score matching within the ESKD cohort, 633 patients with IDD (5.9%) received a kidney transplant compared with 1367 of adults without IDD (12.8%). Adults with IDD were 54% less likely than matched peers without IDD to be evaluated for transplant (odds ratio, 0.46; 95% CI, 0.43-0.50) and 62% less likely to receive a kidney transplant (odds ratio, 0.38; 95% CI, 0.34-0.42). Among matched cohorts of kidney transplant recipients, rates of perioperative complications, readmission, and graft failure were similar for adults with and without IDD.Conclusions and RelevanceUsing the largest cohort of adult kidney transplant recipients with IDD to date, the study team found that rates of evaluation and transplant were lower despite yielding equivalent outcomes. These data support consideration of adults with IDD for kidney transplant and underscore the urgent need for antidiscrimination initiatives to promote the receipt of equitable care for this population.

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“…Some studies also attribute the higher risk of graft loss within this age period to transitioning from pediatric to adult care, yet others did not observe a higher nonadherence or graft failure risk within the transition period 10,12–14 . Several papers describe potential risk factors for poor adherence, including patient‐related factors (e.g., poor knowledge, forgetfulness, side effects, psychological difficulties) as well as family related characteristics (e.g., socioeconomic status, parental oversight of medication intake, poor social support) 5,6,15–17 . In contrast to adult patients, morning doses seem to be more difficult for young patients to remember than evening doses as well as weekends being more difficult than weekdays 18 .…”

Section: Introductionmentioning

confidence: 99%

Medication adherence in pediatric kidney transplantation: How to build a bridge over troubled water

Dobbels,

Wray

2023

Pediatric Transplantation

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Adhering to the immunosuppressive regimen remains one of the biggest challenges for children and adolescents after kidney transplantation. The first paper on nonadherence, co‐authored by Dr. Fine, appeared in Pubmed over 45 years ago. Since then, many clinicians and researchers tried to better understand nonadherence and are looking for effective ways to support young people in implementing the complex medication regimen in their daily lives. As a tribute to Dr. Fine, we conducted a comprehensive review providing an overview of adherence‐enhancing interventions in the field of pediatric kidney transplantation, thereby focusing on strategies that not only are effective but can also be embedded in daily clinical practice successfully and sustainably. This overview is preceded by a discussion about how to find out who is in need of supportive interventions. We will also argue that interventions should already start before pediatric kidney transplantation and discuss how to decide whether or not a young patient with nonadherence‐induced graft loss should undergo retransplantation. We hope this comprehensive overview will rekindle the hope that we can finally turn the tide and beat one of pediatric kidney transplantation's main enemies.

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The psychosocial needs of adolescent and young adult kidney transplant recipients, and associated interventions: a scoping review

Cited by 12 publications

References 67 publications

Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China

Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China

Comparing Kidney Transplant Rates and Outcomes Among Adults With and Without Intellectual and Developmental Disabilities

Medication adherence in pediatric kidney transplantation: How to build a bridge over troubled water

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