Psychosocial Outcomes in Living Kidney Donors: Predictors and Processes

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Living kidney donation, the gift of a kidney from one individual to another for the purposes of transplantation, is a practice which goes against some of the most fundamental principles of medical ethics. Traditionally, it has been justified on the basis that the donor will benefit psychologically from donating, however data are limited that demonstrate this to be the case.
The aim of this mixed-methods thesis was to explore the psychosocial aspects of living kidney donation, and to determine whether both positive and negative physical and psychosocial outcomes could be predicted. A qualitative study using in-depth interviews was conducted to identify the pertinent issues and to generate hypotheses. This included 23 pre- and post-operative living kidney donors. It was followed by a longitudinal quantitative study which utilised a number of both validated questionnaires and purposely designed questions to prospectively measure different psychosocial and transplant factors pre- and post-operatively. One-hundred living kidney donors participated.
Additionally, a wound healing study was conducted to determine whether preoperative psychological factors had an effect on physical recovery. The surgical wounds of 58 living kidney donors were scanned using high-resolution ultrasound to see whether rates of wound healing were influenced by stress, personality and optimism.
The final study explored unspecified kidney donation; a practice whereby individuals choose to donate a kidney to a stranger on the waiting list. As these donors do not know the recipient of their donation there is a concern that psychosocial outcomes in this group may differ to outcomes in specified donors (those donating to someone they know). A national consecutive sample of unspecified kidney donors was recruited to a retrospective questionnaire study. Questionnaire responses from 148 unspecified donors were compared with 148 specified donors; thus making it the world’s largest study of unspecified donation.
Date of Award2015
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorJohn Weinman (Supervisor)

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