Sheila M Quinn1, Hilda Fernandez2, Taylor McCorkle1, Rachel Rogers3, Saarah Hussain4, Carol A Ford1, Frances K Barg5, Kenneth R Ginsburg1, Sandra Amaral6,7. 1. Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA. 2. Division of Nephrology, Columbia University, New York, NY. 3. Biostatistics and Data Management Core, Children's Hospital of Philadelphia, Philadelphia, PA. 4. Hahnemann University Hospital and Drexel College of Medicine, Philadelphia, PA. 5. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA. 6. Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA. 7. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA.
Abstract
PURPOSE: AYAs with KTs experience high rates of premature allograft loss during the HCT. There is a critical need to identify protective factors associated with stable HCT. Resilience-the ability to adapt and thrive in the setting of adversity-has known positive impact on health outcomes. This study explored the novel role of resilience constructs as protective factors in securing stable HCT among AYA with KT. METHODS: We conducted semi-structured interviews of adolescents and young adults who transitioned from a single pediatric transplant center to multiple adult nephrology centers between 2010 and 2017. Interviews explored the role of key resilience constructs in participants' lives around the time of HCT. Participants were stratified into stable or unstable HCT groups based on biological markers of allograft function and clinical data from chart review. Content analyses of interview transcripts were reviewed and compared among HCT groups. RESULTS: Thirty-two participants enrolled (17 stable; 15 unstable). Key resilience constructs more salient in the stable versus unstable HCT group were confidence in and connection to one's healthcare team. Reports of healthcare self-management competencies were similar across both HCT groups. CONCLUSIONS: Confidence in and connection to one's healthcare team appear to be linked with a stable HCT among AYA with KT. This suggests that interdependence, the ability to foster connections with and elicit support from healthcare providers, as opposed to complete independence or autonomy, which is often advised in the HCT process, is a critical component of resilience linked to stable HCT.
PURPOSE: AYAs with KTs experience high rates of premature allograft loss during the HCT. There is a critical need to identify protective factors associated with stable HCT. Resilience-the ability to adapt and thrive in the setting of adversity-has known positive impact on health outcomes. This study explored the novel role of resilience constructs as protective factors in securing stable HCT among AYA with KT. METHODS: We conducted semi-structured interviews of adolescents and young adults who transitioned from a single pediatric transplant center to multiple adult nephrology centers between 2010 and 2017. Interviews explored the role of key resilience constructs in participants' lives around the time of HCT. Participants were stratified into stable or unstable HCT groups based on biological markers of allograft function and clinical data from chart review. Content analyses of interview transcripts were reviewed and compared among HCT groups. RESULTS: Thirty-two participants enrolled (17 stable; 15 unstable). Key resilience constructs more salient in the stable versus unstable HCT group were confidence in and connection to one's healthcare team. Reports of healthcare self-management competencies were similar across both HCT groups. CONCLUSIONS: Confidence in and connection to one's healthcare team appear to be linked with a stable HCT among AYA with KT. This suggests that interdependence, the ability to foster connections with and elicit support from healthcare providers, as opposed to complete independence or autonomy, which is often advised in the HCT process, is a critical component of resilience linked to stable HCT.
Authors: Rebekah P Nash; Marci M Loiselle; Jessica L Stahl; Jamie L Conklin; Terra L Rose; Alissa Hutto; Donna M Evon; Jennifer E Flythe; Eileen J Burker Journal: Kidney360 Date: 2022-08-01