Waiting for a Kidney Transplant: Association With Anxiety and Stress

Silva, A.N.; Moratelli, Lucas; Costa, Ana Luísa Soares; Carminatti, Moisés; Bastos, Marcus Gomes; Colugnati, Fernando Antônio Basile; Grincenkov, F.R.S.; Sanders-Pinheiro, Hélady

doi:10.1016/j.transproceed.2014.05.020

Cited by 9 publications

(11 citation statements)

References 4 publications

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“…Among 14 (77.8%) patient‐only quantitative studies, most assessed anxiety and/or depression (9, 64.3%) followed by quality of life (6, 42.9%). Eleven to 98% of patients reported clinical anxiety or depression (median 64.0%) 28,46,48,56,63,67 . Other studies reported mean anxiety: 14.7 (SD 8.6), 23.1 (SD 5.5), 8.6 (SD 4.6) or mean depression: 14.7 (SD 8.6), 11.8 (SD 3.3) 43,48,58 .…”

Section: Resultsmentioning

confidence: 96%

The psychological burden of waiting for procedures and patient‐centred strategies that could support the mental health of wait‐listed patients and caregivers during the COVID‐19 pandemic: A scoping review

Gagliardi

Yip

Irish

et al. 2021

Health Expectations

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Background Waiting for procedures delayed by COVID‐19 may cause anxiety and related adverse consequences. Objective To synthesize research on the mental health impact of waiting and patient‐centred mitigation strategies that could be applied in the COVID‐19 context. Methods Using a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes. Results We included 51 studies that focussed on organ transplant (60.8%), surgery (21.6%) or cancer management (13.7%). Most patients and caregivers reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socio‐economic status, or with less‐positive coping ability. Six studies evaluated educational strategies to develop coping skills: 2 reduced depression (2 did not), 1 reduced anxiety (2 did not) and 2 improved quality of life (2 did not). In contrast, patients desired acknowledgement of concerns, peer support, and periodic communication about wait‐list position, prioritization criteria and anticipated procedure date. Conclusions Findings revealed patient‐centred strategies to alleviate the mental health impact of waiting for procedures. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers, particularly in the COVID‐19 context. Patient or Public Contribution Six patients and four caregivers waiting for COVID‐19‐delayed procedures helped to establish eligibility criteria, plan data extraction and review a draft and final report.

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Section: Resultsmentioning

confidence: 96%

The psychological burden of waiting for procedures and patient‐centred strategies that could support the mental health of wait‐listed patients and caregivers during the COVID‐19 pandemic: A scoping review

Gagliardi

Yip

Irish

et al. 2021

Health Expectations

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“…The ongoing burden of medical, surgical, and psychosocial testing in the transplant assessment process, uncertainty of receiving a deceased donor kidney, and fears of discrimination have been reported in kidney transplant candidates . To some extent, this may explain the high prevalence of stress and anxiety, which is associated with longer wait‐list time . Also, patient perceptions of prognosis and transplant candidacy have been found to influence treatment decision‐making and goals of care .…”

Section: Introductionmentioning

confidence: 99%

‘Suspended in a paradox’-patient attitudes to wait-listing for kidney transplantation: systematic review and thematic synthesis of qualitative studies

et al. 2015

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Summary Patients on waiting lists for kidney transplantation have higher mortality rates and have specific anxieties about their eligibility, process, and outcomes of wait‐listing. We aimed to describe patient experiences and attitudes to wait‐listing for kidney transplantation. Electronic databases were searched to September 2014. Thematic synthesis was used to analyze the findings. From 22 studies (n = 795 patients), we identified six themes: accepting the only option (chance to regain normality, avoiding guilt, impulsive decision‐making); maintaining hope (determined optimism, appreciating a fortuitous gift, enduring for optimal outcomes, trust in clinical judgment); burden of testing (strenuous commitment, losing the battle, medical mistrust); permeating vulnerability (eligibility enigma, being threatened, angst of timing uncertainty, desperate urgency, living in limbo, spiraling doubt and disappointment, residual ambivalence); deprived of opportunity (unfairly dismissed, unexpected disqualification, self‐resignation and acceptance, jealousy, suspicious of inequity); and moral guilt (awaiting someone's death, questioning deservingness). The waiting list offered hope of restored normality. However, the demands of workup, uncertainty about eligibility, and waiting times that exceeded expectations impelled patients to disillusionment, despair, and suspicion of inequity. Managing patient expectations and ensuring transparency of wait‐listing and allocation decisions may allay patient disappointment and skepticism, to improve patient satisfaction and treatment outcomes.

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“…Additionally, the design did not include a control group. It is possible that while anxiety and depressive symptoms remained stable in the participants receiving cognitive behavioral stress management, symptoms would have worsened (Corruble et al, 2010) in control participants due to increasing stress associated with lengthening duration of time on the waitlist (Silva et al, 2014). Another possible explanation for the lack of significant effects is that there was no distress level cutoff required for inclusion.…”

Section: Discussionmentioning

confidence: 99%

The feasibility of a group stress management Liver SMART intervention for patients with end-stage liver disease: A pilot study

et al. 2018

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Twenty-nine English-speaking United Network for Organ Sharing-registered patients with end-stage liver disease from a single transplantation center enrolled in 8-week, group cognitive-behavioral liver stress management and relaxation training intervention adapted for patients with end-stage liver disease. Patients completed pre- and postintervention surveys that included the Beck Depression Inventory II and the Beck Anxiety Inventory. Feasibility, acceptability, tolerability, and preliminary efficacy were assessed.ResultAttendance rate was 69.40%. The intervention was rated as "good" to "excellent" by 100% of participants who completed the postintervention survey in teaching them new skills to relax and to cope with stress, and by 94.12% of participants in helping them feel supported while waiting for a liver transplant. No adverse events were recorded over the course of treatment. Attrition was 13.79%. Anxious and depressive symptoms were not statistically different after the intervention.Significance of resultsThe liver stress management and relaxation training intervention is feasible, acceptable, and tolerable to end-stage liver disease patients within a transplant clinic setting. Anxious and depressive symptoms remained stable postintervention. Randomized controlled trials are needed to study the intervention's effectiveness in this population.

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Waiting for a Kidney Transplant: Association With Anxiety and Stress

Cited by 9 publications

References 4 publications

The psychological burden of waiting for procedures and patient‐centred strategies that could support the mental health of wait‐listed patients and caregivers during the COVID‐19 pandemic: A scoping review

The psychological burden of waiting for procedures and patient‐centred strategies that could support the mental health of wait‐listed patients and caregivers during the COVID‐19 pandemic: A scoping review

‘Suspended in a paradox’-patient attitudes to wait-listing for kidney transplantation: systematic review and thematic synthesis of qualitative studies

The feasibility of a group stress management Liver SMART intervention for patients with end-stage liver disease: A pilot study

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