Browse > Article
http://dx.doi.org/10.7586/jkbns.2019.21.4.249

Psychosocial Assessment and Related Factors for Kidney Transplantation Candidates in South Korea: A Descriptive Correlational Study  

Chong, Hye Jin (College of Nursing, The University of Illinois at Chicago)
Publication Information
Journal of Korean Biological Nursing Science / v.21, no.4, 2019 , pp. 249-258 More about this Journal
Abstract
Purpose: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status. Methods: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT. Results: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk. Conclusion: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.
Keywords
Kidney transplantation; Waiting lists; Psychology; Nursing assessments;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Dew MA, Rosenberger EM, Myaskovsky L, DiMartini AF, Dabbs AJ, Posluszny DM, et al. Depression and anxiety as risk factors for morbidity and mortality after organ transplantation: a systematic review and meta-analysis. Transplantation. 2015; 100(5):988. https://doi.org/10.1097/TP.0000000000000901   DOI
2 Lerret S, Cupples S, Ohler L, McCalmont V. Core curriculum for transplant nurses. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2016. p.956-972.
3 Maldonado JR, Dubois HC, David EE, Sher Y, Lolak S, Dyal J, et al. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics. 2012; 53(2):123-132. https://doi.org/10.1016/j.psym.2011.12.012   DOI
4 Freischlag KW, Chen V, Nagaraj SK, Chua AN, Chen D, Wigfall DR, et al. Psychosocial assessment of candidates for transplantation (PACT) score identifies high risk patients in pediatric renal transplantation. Frontiers in Pediatrics. 2019;7:1-6. https://doi.org/10.3389/fped.2019.00102   DOI
5 Rodrigue JR, Mandelbrot DA, Pavlakis M. A psychological intervention to improve quality of life and reduce psychological distress in adults awaiting kidney transplantation. Nephrology Dialysis Transplantation. 2010;26(2):709-715. https://doi.org/10.1093/ndt/gfq382   DOI
6 Olbrisch ME, Levenson JL, Hamer R. The PACT: a rating scale for the study of clinical decision-making in psychosocial screening of organ transplant candidates. Clinical Transplantation. 1989;3(3):164-169.
7 Schneekloth TD, Hitschfeld MJ, Petterson TM, Narayanan P, Niazi SK, Jowsey-Gregoire SG, et al. Psychosocial risk impacts mortality in women after liver transplantation. Psychosomatics. 2019; 60(1):56-65. https://doi.org/10.1016/j.psym.2018.06.008   DOI
8 Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. Public Library of Science Medicine. 2012; 11(9):e1001307. https://doi.org/10.1371/journal.pmed.1001307
9 Hitschfeld MJ, Schneekloth TD, Kennedy CC, Rummans TA, Niazi SK, Vasquez AR, et al. The psychosocial assessment of candidates for transplantation: a cohort study of its association with survival among lung transplant recipients. Psychosomatics. 2016; 57(5):489-497. https://doi.org/ 10.1016/j.psym.2016.05.003   DOI
10 Korean ESRD Resgistry Commitee. Current Renal Replacement Therapy in Korea. Final report. Seoul: Korean Society of Nephrology; 2019 June. Report No.: Annual Meeting of KSN 2019.
11 Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. American Journal of Transplantation. 2011; 11(10):2093-109. https://doi.org/10.1111/j.1600-6143.2011.03686.x   DOI
12 Reese PP, Shults J, Bloom RD, Mussell A, Harhay MN, Abt P, et al. Functional status, time to transplantation, and survival benefit of kidney transplantation among wait-listed candidates. American Journal of Kidney Diseases. 2015; 66(5):837-45. https://doi.org/10.1053/j.ajkd.2015.05.015   DOI
13 Korean Network for Organ Sharing (KONOS). Statistics Annual Report 2017. Seoul; Korean Network for Organ Sharing; 2018.
14 Cho WH. Status of Organ Donation and Solution of Organ Shortage in Korea. The Journal of the Korean Society for Transplantation. 2018; 32(3):38-48. https://doi.org/10. 4285/ jkstn. 2018.32.3.38   DOI
15 Hernandez D, Castro-de la Nuez P, Muriel A, Ruiz-Esteban P, Alonso M. Mortality on a renal transplantation waiting list. Nefrologia (English Edition). 2015; 35(1):18-27. https://doi.org/10.3265/Nefrologia.pre2014.Oct.12681
16 Akolekar D, Forsythe JL, Oniscu GC. Impact of patient characteristics and comorbidity profile on activation of patients on the kidney transplantation waiting list. Transplant Proceedings. 2013; 45(6):2115-2122. https://doi: 10.1016/j.transproceed.2013.03. 0 33.   DOI
17 Napolitano MA, Babyak MA, Palmer S, Tapson V, Davis RD, Blumenthal JA, et al. Effects of a telephone-based psychosocial intervention for patients awaiting lung transplantation. Chest. 2002; 122(4):1176-1184. https://doi.org/10.1378/chest.122.4.1176   DOI
18 LI PK, Chu KH, Chow KM, Lau MF, Leung CB, Kwan BC, et al. Cross sectional survey on the concerns and anxiety of patients waiting for organ transplants. Nephrology. 2012; 17(5):514-518. https://doi.org/10.1111/j.1440-1797.2012.01615.x   DOI
19 Presberg BA, Levenson JL, Olbrisch ME, Best, AM. Rating scales for the psychosocial evaluation of organ transplant candidates: Comparison of the PACT and TERS with bone marrow transplant patients. Psychosomatics. 1995; 36(5):458-461. https://doi.org/10.1016/S0033-3182(95)71626-7   DOI
20 Pieloch D, Dombrovskiy V, Osband AJ, DebRoy M, Mann RA, Fernandez S, et al. The Kidney Transplant Morbidity Index (KTMI): a simple prognostic tool to help determine outcome risk in kidney transplant candidates. Progress in Transplantation. 2015; 25(1):70-76. https://doi.org/10.7182/pit2015462   DOI
21 Craig JA, Miner D, Remtulla T, Miller J, Zanussi LW. Piloting a coping skills group intervention to reduce depression and anxiety symptoms in patients awaiting kidney or liver transplant. Health & Social Work. 2017; 42(1):44-52. https://doi-org.proxy.10.1093/hsw/hlw064
22 Gordon EJ, Reddy E, Ladner DP, Friedewald J, Abecassis MM, Ison MG. Kidney transplant candidates' understanding of increased risk donor kidneys: a qualitative study. Clinical Transplantation. 2012; 26(2):3593-68. https://doi.org/10.1111/j.1399-0012.2011.01536.x
23 Warsame F, Haugen CE, Ying H, Garonzik-Wang JM, Desai NM, Hall RK, et al. Limited health literacy and adverse outcomes among kidney transplant candidates. American Journal of Transplantation. 2019; 19(2):457-465. https://doi.org/10.1111/ajt.14994   DOI
24 McAdams-DeMarco MA, King EA, Luo X, Haugen C, DiBrito S, Shaffer A, et al. Frailty, length of stay, and mortality in kidney transplant recipients: a national registry and prospective cohort study. Annals of Surgery. 2017; 266(6):1084. https://doi.org/10.1097/SLA.0000000000002025   DOI
25 Corruble E, Durrbach A, Charpentier B. Lang P, Amidi S, Dezamis A, et al. Progressive increase of anxiety and depression in patients waiting for a kidney transplantation. Behavioral Medicine. 2010; 36(1):32-36. https://doi.org/10.1080/08964280903521339   DOI
26 Maltby MC, Flattery MP, Burns B, Salyer J, Weinland S, Shah KB. Psychosocial assessment of candidates and risk classification of patients considered for durable mechanical circulatory support. The Journal of Heart and Lung Transplantation.2014; 33(8):836-841. https://doi.org/10.1016/j.healun.2014.04.007   DOI
27 Hitschfeld MJ, Schneekloth TD, Kennedy CC, Rummans TA, Niazi SK, Vasquez AR, et al. The psychosocial assessment of candidates for transplantation: a cohort study of its association with survival among lung transplant recipients. Psychosomatics. 2016; 57(5):489-497. https://doi.org/10.1016/j.psym.2016.05.003   DOI
28 Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney International. 2009; 75(11):1223-1229. https://doi.org/10.1038/ki.2009.51   DOI
29 Rodrigue JR, Mandelbrot DA, Pavlakis M. A psychological intervention to improve quality of life and reduce psychological distress in adults awaiting kidney transplantation. Nephrology Dialysis Transplantation. 2010; 26(2):709-15. https://doi.org/ 10.1093 /ndt/ gfq382   DOI
30 Gill JS, Tonelli M, Johnson N, Kiberd B, Landsberg D, Pereira BJ. The impact of waiting time and comorbid conditions on the survival benefit of kidney transplantation. Kidney International. 2005; 68(5):2345-2351. https://doi.org/10.1111/j.1523-1755.2005.00696.x   DOI