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- Forsberg, Anna, 1969, et al.
(författare)
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The essence of living parental liver donation--donors' lived experiences of donation to their children.
- 2004
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Ingår i: Pediatric transplantation. - : Wiley. - 1397-3142 .- 1399-3046. ; 8:4, s. 372-80
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Tidskriftsartikel (refereegranskat)abstract
- The use of living parental liver donors will continue and probably increase because of lack of cadaveric livers for paediatric transplantation and the excellent graft survival of parental livers. Therefore, it is important for the health care professionals involved in living parental liver donation to understand the experience of being a liver donor. The aim of this study was to investigate the expressed deeper feelings of parents who donated a part of their liver to their own child. The study took the form of in-depth interviews with 11 donors. All donors were biological parents of the recipient, nine fathers and two mothers. The interpretive phenomenology method was used, and interpretive analysis was carried out in three interrelated processes in line with Benner. Data collection was guided by the researcher's preliminary understanding of the donor experience from being involved in the surgery and care of the donors as well as the paediatric recipients. However, the research question was approached from the perspective of holistic care for the donor. In this study, the essence of living parental liver donation was found to be the struggle for holistic confirmation. There were three categories leading to this central theme; the total lack of choice, facing the fear of death and the transition from health to illness. There was total agreement among the respondents that there is no choice when it comes to the question of donation. The findings in this study stress the importance of organizing the parental liver donation programme with as much focus on the donor as on the child. Based on the results of this study, several clinical implications are suggested for the formation of guidelines for living parental liver donation.
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- Nilsson, Madeleine, 1964, et al.
(författare)
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Coping in relation to perceived threat of the risk of graft rejection and Health-Related Quality of Life of organ transplant recipients
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 27:4, s. 935-944
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Tidskriftsartikel (refereegranskat)abstract
- The most serious risk connected with transplantations besides infection is graft rejection. Organ transplant recipients (OTRs) perceive graft rejection as a stress factor and a threat. The primary aim of the present study was to examine types of coping used to handle the threat of the risk of graft rejection among OTRs and to investigate relations between coping and perceived threat as well as Health-Related Quality of Life (HRQoL). A second aim was to test the General Coping Questionnaire (GCQ) for reliability in relation to the threat of the risk of graft rejection. Three different questionnaires, the Perceived Threat of the Risk of Graft Rejection (PTGR), GCQ and the SF-36, were mailed to 229 OTRs between 19 and 65years old. Patients were transplanted with a kidney, a liver or a heart and/or a lung. All patients with follow-up time of 1year +/- 3months and 3years +/- 3months were included. With an 81% response rate, the study comprised of 185 OTRs. The differences between the transplanted organ groups in their use of coping were small. Likewise, coping related weakly with sex, age, time since transplantation and whether they had experienced graft rejections or not. The respondents tended in general to use more of the positive' coping (strategies related to positive well-being). The measured coping in relation to the perceived threat of the risk of graft rejection seem to be relatively stable over time and quite independent of demographic and clinical variables.
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- Nilsson, Madeleine, 1964, et al.
(författare)
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Perceptions of experiences of graft rejection among organ transplant recipients striving to control the uncontrollable.
- 2008
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Ingår i: Journal of clinical nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 17:18, s. 2408-17
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate perceptions of graft rejection and different methods to obtain knowledge about graft rejection among adult organ transplant recipients. BACKGROUND: Rejection is the most common cause of graft loss and graft dysfunction in clinical transplantation. Little is known about the recipients' own explanation models related to graft rejection. DESIGN: Phenomenography. METHOD: A strategic selection included patients who had undergone a kidney, liver, heart or lung transplant. Sixteen patients, six males and 10 females, aged 21-63 years with a follow-up time of between three months and 10 years were interviewed. RESULTS: The result comprised five domains of variations in perceptions of graft rejection: the abstract threat to life; the concrete threat to health; trust in the body; striving to control the threat; and one's identity. The inner perspective and personal explanation models involved threat, fear, trust, control and identity adjustment. Different approaches had the same purpose; 'striving to control the uncontrollable'. CONCLUSION: Learning about graft rejection revealed security, lack of security and uncertainty. RELEVANCE TO CLINICAL PRACTICE: The inner perspective of graft rejection in this result leads to several clinical implications in terms of patient education and recipients' differing ways of obtaining knowledge about graft rejection. We suggest that patient's education should be tailored in a different way, offering support and advice in line with their personal models of explanation of graft rejection as a complement to the explanation from the biomedical model of disease.
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| 6. |
- Nilsson, Madeleine, 1964
(författare)
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The percieved threat of the risk of graft rejection among organ transplant recipients
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Transplantation is an established and successful treatment for critically ill patients. For many of the organ transplant recipients (OTR) it is the only option for survival. When OTRs are asked about what they fear the most, the most common answer is graft rejection. Graft rejection is a real threat against an OTR since it is the body’s natural way, through its immunological defence, to protect itself against foreign bodies or unknown substances. Aim: The primary aim of this thesis was to explore the risk of graft rejection from the perspective of OTRs by describing the characteristics of the threat experience. A secondary aim was to investigate the relationships between the perceived threat of the risk of graft rejection, by means of a domain specific questionnaire, and selected associated factors such as coping strategies and Health Related Quality of Life (HRQoL). Methods: The efforts to acquire scientific knowledge included seeking the unique in each individual case as well as group correlations. For this reason, the data collection methods were both inductive and deductive and included interviews and questionnaires. The study group consisted of 1) 16 adult OTR, 2) 8 adolescent OTR, 3) 185 adult OTR, 4)185 adult OTR. The instruments used to collect data were SF-36, General Coping Questionnaire (GCQ) and the Perceived Threat of the risk of Graft Rejection (PTGR) which was developed for the purpose in this thesis. Data analysis was performed mainly by descriptive and parametric statistical methods as well as by the use of phenomenography. Results: Adult OTRs perceived graft rejection in various ways involving five domains; abstract threat to life, concrete threat to health, trust in the body, striving to control the threat and one’s identity. There were also various ways of learning about graft rejection involving three domains; experience of graft rejection that was accompanied by symptoms and personal observations, experience of graft rejection in the absence of physical symptoms and personal observations and no experience of graft rejection. The adolescents’ perceptions were grouped into seven domains: tests and examinations, transplantation, medication, graft rejection as a condition, graft rejection and its consequences, friends and oneself as an organ transplant recipient. It was possible to develop an instrument for measuring the perceived threat of graft rejection and three homogenous and psychometrically sound factors were identified. These were labelled intrusive anxiety, graftrelated threat and lack of control. A majority (74 %) reported a low level of intrusive anxiety. The kidney transplant recipients reported more graft related threat than other OTRs. The differences between the transplanted organ groups in their use of coping strategies were small. Likewise, coping related very weakly with sex, age, time since transplantation and whether they had experienced graft rejections or not. The respondents tended in general to use more of ‘positive’ coping strategies (strategies related to positive well-being). Conclusion: OTRs perceive the risk of graft rejection in various ways, from nonthing to worry about to the threat of death. It was possible to measure the perceived threat of graft rejection among OTRs with an instrument comprising twelve items. Perceptions and coping seem to be independent of demographic and clinical variables such as type of organ transplanted, time since transplantation and experiences of graft rejection, age and sex.
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