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Donor and recipient views on their relationship in living kidney donation : Thematic synthesis of qualitative studies
Ralph, Angelique F. Butow, Phyllis Hanson, Camilla S. Chadban, Steven J. Chapman, Jeremy R. Craig, Jonathan C. Kanellis, John Luxton, Grant Tong, Alison
Ralph, Angelique F.
Butow, Phyllis
Hanson, Camilla S.
Chadban, Steven J.
Chapman, Jeremy R.
Craig, Jonathan C.
Kanellis, John
Luxton, Grant
Tong, Alison
Abstract
Background
Many donors and recipients report an improved relationship after transplantation; however, tension, neglect, guilt, and proprietorial concern over the recipient can impede donor and recipient well-being and outcomes. We aimed to describe donor and recipient expectations and experiences of their relationship in the context of living kidney donation.
Study Design
Thematic synthesis of qualitative studies.
Setting & Population
Living kidney donors and recipients.
Search Strategy & Sources
Electronic databases were searched to October 2015.
Analytical Approach
Thematic synthesis.
Results
From 40 studies involving 1,440 participants (889 donors and 551 recipients) from 13 countries, we identified 6 themes. “Burden of obligation” described the recipient’s perpetual sense of duty to demonstrate gratitude to the donor. “Earning acceptance” was the expectation that donation would restore relationships. “Developing a unique connection” reflected the inexplicable bond that donor-recipient dyads developed postdonation. “Desiring attention” was expressed by donors who wanted recognition for the act of donation and were envious and resentful of the attention the recipient received. “Retaining kidney ownership” reflected the donor’s inclination to ensure that the recipient protected “their” kidney. “Enhancing social participation” encompassed relieving both the caregiver from the constraints of dialysis and the recipient from increased involvement and contribution in family life.
Limitations
Non-English articles were excluded.
Conclusions
Living kidney donation can strengthen donor-recipient relationships but may trigger or exacerbate unresolved angst, tension, jealousy, and resentment. Facilitating access to pre- and posttransplantation psychological support that addresses potential relationship changes may help donors and recipients better adjust to changes in the relationship dynamics, which in turn may contribute to improved psychosocial and transplantation outcomes following living kidney donation.
Keywords
living kidney donation, kidney donor, kidney transplant recipient, psychosocial issues, donor-recipient relationship, qualitative research, relationship processes, interpersonal relationships, emotional outcomes, thematic synthesis
Date
2017
Type
Journal article
Journal
American Journal of Kidney Diseases
Book
Volume
69
Issue
5
Page Range
602-616
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled
Notes
© 2016 by the National Kidney Foundation, Inc.