Living kidney donors' experiences while undergoing evaluation for donation: a qualitative study

J Clin Nurs. 2015 Aug;24(15-16):2258-67. doi: 10.1111/jocn.12776. Epub 2015 Mar 9.

Abstract

Aim and objective: To explore living kidney donors' experiences during the donor evaluation process.

Background: Due to a shortage of organs for kidney transplantation from deceased donors, the living kidney donation rate has increased. The time period until transplantation is often shorter when using living donors compared to deceased donors. Although technological developments in immunology have made it possible to perform successful kidney transplants between donors and recipients, a large disparity still exists between the number of patients needing a kidney transplant and the supply of kidneys from living donors. This need has promoted donation from living kidney donors. The evaluation phase prior to donation is a crucial period in the recruitment of living kidney donors, as it ensures that donors are physically and mentally suitable for donation.

Design: A qualitative study taking a phenomenological-hermeneutic approach.

Methods: Data were generated using participant observation during the evaluation period and semi-structured interviews after conclusion of the evaluation. In total, 18 potential donors were included. Data were interpreted and discussed in accordance with Ricoeur's theory of interpretation: naïve reading, structural analysis, critical interpretation and discussion.

Results: Feelings of hope concerning acceptance as a donor and concerns for the recipient's illness and everyday life were evident during evaluation. Donors' experiences largely depended on the quality of their communication and interaction with the healthcare professionals. In some cases, donors were supported and cared for, while in other cases, frustrations and vulnerability were evident and emotional support and attention to donors' needs were not present.

Conclusion: The evaluation period for living kidney donation involves hope, vulnerability and concern. Interaction, communication and support from healthcare professionals to help donors manage this crucial phase are essential. Accordingly, the identification of donors' specific care and support needs, including physical, mental and ethical factors, is key to a positive experience.

Relevance to clinical practice: The attention, commitment and engagement of healthcare professionals are essential elements in the identification of donors' individual needs.

Keywords: evaluation; living kidney donation; participant observation; patient experiences; semi-structured interview.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Denmark
  • Female
  • Humans
  • Interviews as Topic
  • Kidney Transplantation / nursing
  • Kidney Transplantation / psychology*
  • Living Donors / psychology*
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Prospective Studies