‘It seemed churlish not to’: How living non-directed kidney donors construct their altruism

Challenor, Julianna; Watts, Jay

doi:10.1177/1363459313501358

Cited by 22 publications

(29 citation statements)

References 32 publications

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“…20,21 This may represent a response that is highly influenced by the psychological benefits of donation. 22,23 The finding illustrates the important interplay between patient characteristics and individual domains of pain perception. This observation argues against opinion that the only way to improve pain management is the strict use of protocols for monitoring and administering analgesics.…”

Section: Discussionmentioning

confidence: 80%

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Early Postoperative Pain and its Predictors in the Adult to Adult Living Donor Liver Transplantation Cohort Study

et al. 2016

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Background Little is known about how well postoperative pain is managed in living liver donors, despite pain severity being the strongest predictor of persistent pain with long-lasting disability. Methods We conducted a prospective multicenter study of 172 living liver donors. Self-reported outcomes for pain severity, activity interference, affective (emotional) reactions, adverse effects to treatment, and perceptions of care were collected using the American Pain Society Patient Outcomes Questionnaire-Revised. Mixed effects linear regression was used to identify demographic and psychosocial predictors of subscale scores. Results Donors were young (36.8±10.6) and healthy. Of 12 expert society analgesic recommendations for postoperative pain management, 49% received care conforming to 3 guidelines, and only 9% to 4 or 5. More than half reported adverse effects to analgesic treatment for moderate to severe pain that interfered with functional activity; however, emotional distress to pain was unexpectedly minimal. Female donors had higher affective (Beta=0.88, p=0.005) and adverse effects scores (Beta=1.33, p<0.001). Donors with 2 or more medical concerns prior to surgery averaged 1 unit higher pain severity, functional interference, adverse effects, and affective reaction subscale scores (Beta range 1.06–1.55, all p<0.05). Receiving information about pain treatment options increased perception of care subscale scores (Beta=1.24, p=0.001), while depressive symptoms before donation were associated with lower scores (Beta=-1.58, p=0.01). Conclusions Donors have a distinct profile of pain reporting that is highly influenced by psychological characteristics. Interventions to improve pain control should consider modifying donor behavioral characteristics in addition to optimizing pain care protocols.

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Section: Discussionmentioning

confidence: 80%

“…In-depth qualitative analysis has shown “discouraging donation” produces interpersonal stress and emotional distress due to conflict with social ties. 23,31 It is possible that social conflict due to disagreement about donation could lead to emotional distress that is expressed in response to pain.…”

Section: Discussionmentioning

confidence: 99%

Early Postoperative Pain and its Predictors in the Adult to Adult Living Donor Liver Transplantation Cohort Study

et al. 2016

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“…Clarke et al () however have indicated that there are stages within the donation procedure that are experienced as difficult for the donor and may influence their commitment to continue with donation. A significant potential barrier includes negative evaluations of their decision from members of their primary social group (PSG), peers and healthcare professionals (Jacobs et al ; Massey et al ; Clarke et al ; Challenor & Watts ). The PSG has been defined as a network of relationships characterised by extensive interaction, strong emotional ties, and endurance over time (Cooley ).…”

Section: Introductionmentioning

confidence: 99%

“…The PSG can therefore include both family members and those with whom donors have close friendships. UKDs often reported encountering scepticism and resistance from members of their PSG (as well as wider community members) and described needing to be determined to overcome such resistance to proceed to donation (Clarke et al ; Challenor & Watts ). Furthermore, disapproval from ‘key others’ has been highlighted as a barrier to living donation in general (Hyde & White ).…”

Section: Introductionmentioning

confidence: 99%

Key experiences of primary social groups in Unspecified Kidney Donation

Clarke

Mitchell

Williams

et al. 2019

Journal of Renal Care

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SUMMARY Background The role of family members in directed kidney donation is well documented in the literature from both a physiological and psychosocial perspective. The experiences of families, or primary social groups (PSGs), where one member considers donating a kidney via unspecified altruistic kidney donation route (UKD) is poorly understood. This is pertinent as lack of family support has been identified as a potential contributor to donation withdrawal. Objectives This study aimed to explore the relevant psychosocial factors underpinning completed and uncompleted donations. Design A qualitative study using semi–structured interviews. Participants Qualitative interviews were conducted in the United Kingdom with 35 individuals comprising of: 11 donors who donated their kidney altruistically and 8 of their PSG members, and 11 donors who withdrew and 5 of their PSG members. Approach Interviews were transcribed verbatim and analysed using Framework Analysis. Results Two major themes were identified: (1) Supportability, which contained experiences fundamental to proceeding to donate, underpinned by four subthemes Acceptability, Awareness and Information, Family Risk and Ambivalence;(2) Seeking Resolution, contained discussions of experiences following either withdrawal from or completion of the donation, and comprised two sub–themes, Unfinished Business and Resolve. Conclusions There are key differences in the experiences between those who completed their donation and those who withdrew. It is clear from this study that UKD operates within a PSG's social framework. Clinical implications suggest interventions at the level of addressing ambivalence within the PSG and the need for promotion of better psychosocial outcomes both following completion or withdrawal from donation.

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“…31 Non-directed altruistic donors, much like directed donors, report being motivated by a desire to benefit other people or society as a whole, a compelling desire to donate and recognise personal psychosocial gains. [32][33][34] Where commercial organ trading exists, or where donation is financially incentivised, most unrelated donors report financial motivation. [35][36][37][38] Payment for donation is illegal in almost all countries.…”

mentioning

confidence: 99%