Objectives Living donor kidney transplantation is currently the preferred treatment for patients with end-stage renal disease. A subgroup of the kidney donor population experiences adjustment problems during or after the donation procedure (eg, anxiety or fatigue). There is a need for evidence-based interventions that decrease donation-related difficulties before or after donation. In the current study, a guided and tailored internet-based cognitive-behavioural therapy (ICBT) intervention for donors and donor candidates was developed and the feasibility and perceived effectiveness were evaluated.
Design Pilot study including qualitative and quantitative research methods for intervention development and evaluation.
Setting Living kidney donor population of two Dutch transplantation centres.
Participants Donors and healthcare professionals participated in focus group interviews conducted to identify intervention themes and to map attitudes towards internet-based interventions. In a pilot feasibility study, 99 donors and donor candidates participated, of whom 38 completed the screening. Eight donors or donor candidates with a risk profile (ie, impaired mental health-related quality of life (HRQoL)) received and evaluated the intervention.
Interventions A guided and tailored ICBT intervention for donors and donor candidates was developed. Donation-related treatment modules, assignments and psychoeducation were integrated within an existing disease-generic ICBT intervention.
Outcome measures HRQoL, anxiety and depression were assessed before and after the ICBT intervention. Additional questionnaires were included to identify specific problem areas of donor functioning to tailor the ICBT intervention to the donor’s needs.
Results Different intervention themes were derived from the focus group interviews (eg, physical limitations, and donation-specific emotional and social-relational problems). Participants were satisfied about the intervention content (7.7±0.8 on a 0–10 scale) and the therapeutic relationship (4.4±0.6 on a 1–5 scale), and indicated an improvement on domains of their treatment goals (3.2±0.7 on a 1–4 scale).
Conclusion This study showed positive evaluations concerning both feasibility and perceived effectiveness of the tailored ICBT intervention in kidney donors and donor candidates, in line with previous studies using comparable ICBT treatment protocols in other populations. Future research should examine the possibilities of integrating the intervention into psychosocial care for kidney donors.
- living kidney donors
- quality of life
- cognitive behavioral therapy
- internet-based intervention
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Contributors LW: participated in research design, coordination/logistics, performance of the research, data analysis, writing of the paper and approval of the article. HvM and AWME: participated in research design, coordination/logistics, data analysis, revising the paper and approval of the article. CWH: participated in coordination/logistics, acquisition of data, revising the paper and approval of the article. TEB: participated in acquisition of data, focus group interviews, coaching participants, revising the paper and approval of the article. SPFH: participated in acquisition of data, focus group interviews, revising the paper and approval of the article. KAMIvdP: participated in acquisition of data, revising the paper and approval of the article. AJH and LBH: participated in research design, coordination/logistics, revising the paper and approval of the article.
Funding This work was supported by the Dutch Kidney Foundation.
Competing interests AWME, HvM and LW received research grants from the Dutch Kidney Foundation. LBH reports personal fees from Novartis and Chiesi (scientific advisory board). All other authors have no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work.
Patient consent Obtained.
Ethics approval The medical ethics committee of the Radboudumc Nijmegen approved the study (NL.50145.091.14).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.
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