Akemi Watanabe1, Tomoko Inoue. 1. Department of Critical and Invasive-Palliated Care Nursing, Graduate School of Health Sciences, Tokyo Medical and Dental University, Japan. tinoue.cc@tmd.ac.jp
Abstract
AIM: This paper is a report of a study conducted to explore the transformational experiences of adult-to-adult living-donor liver transplant recipients. BACKGROUND: Living-donor liver transplant was developed to overcome the shortage of cadaveric livers available for transplantation. However, living-donor liver transplant generates multifaceted psychosocial problems for recipients. METHOD: Data were collected from 2002 to 2004 through in-depth interviews and participant observations. We adopted a phenomenological approach that examined the experience of 30 recipients. FINDINGS: We classified the experiences into three types: common, innate and unrealized. Analysis of the transcripts revealed four themes, all with associated sub-themes. The first theme, guilt and concrete issues, includes anguish when thinking about survival by hurting a potential donor and problems associated with donor and cost. The second theme, let it happen includes leave it to fate; ambivalence; and worry about the donor candidate and whether he/she will change their mind. The third theme, pain, includes extreme physical and mental pain for me and the donor; and worry about cost. The fourth theme, balancing gains and losses, includes grateful for and hoping to enjoy my new life; burden of new body; difficulty in adapting to modified life plan; and changes in family relationships. CONCLUSION: Nursing practice should be developed to (1) give support to patients and their families during decision-making; (2) give support for the dramatic life change; (3) help recipients accept the reality of the transplant; and (4) help achieve the essential balance between feelings of attainment and loss.
AIM: This paper is a report of a study conducted to explore the transformational experiences of adult-to-adult living-donor liver transplant recipients. BACKGROUND: Living-donor liver transplant was developed to overcome the shortage of cadaveric livers available for transplantation. However, living-donor liver transplant generates multifaceted psychosocial problems for recipients. METHOD: Data were collected from 2002 to 2004 through in-depth interviews and participant observations. We adopted a phenomenological approach that examined the experience of 30 recipients. FINDINGS: We classified the experiences into three types: common, innate and unrealized. Analysis of the transcripts revealed four themes, all with associated sub-themes. The first theme, guilt and concrete issues, includes anguish when thinking about survival by hurting a potential donor and problems associated with donor and cost. The second theme, let it happen includes leave it to fate; ambivalence; and worry about the donor candidate and whether he/she will change their mind. The third theme, pain, includes extreme physical and mental pain for me and the donor; and worry about cost. The fourth theme, balancing gains and losses, includes grateful for and hoping to enjoy my new life; burden of new body; difficulty in adapting to modified life plan; and changes in family relationships. CONCLUSION: Nursing practice should be developed to (1) give support to patients and their families during decision-making; (2) give support for the dramatic life change; (3) help recipients accept the reality of the transplant; and (4) help achieve the essential balance between feelings of attainment and loss.