Preventive intervention for living donor psychosocial outcomes: feasibility and efficacy in a randomized controlled trial.
Dew MA, Dimartini AF, et al.American Journal of Transplantation 2013; 13(10): 2672-84.
Aims
To investigate the post donation impact of a preventative intervention utilizing motivational interviewing to target residual ambivalence about donating which is a major risk factor for poor psychosocial outcome.
Interventions
Participants were randomised to one of three interventions; the motivational interviewing (plus standard care) intervention, an active comparison condition to control for the effects of contact time and attention (enhanced standard care) or standard care only.
Participants
113 kidney or liver donors.
Outcomes
The outcomes of the study included post-donation physical health and somatic complaints; the number of physical symptoms related to donation, fatigue in the last week, pain in the last 24 hours, time to recovery, and the number of unexpected medical problems related to donation. Post donation psychological outcomes; depression symptoms, anxiety treatments, negative feelings about the donation and the family relationship outcomes; quality of relationship with spouse, quality of relationship with family and the number of unexpected family problems related to donation.
Follow-up
3 months.
CET Conclusions
Simmons ambivalence score was used to identify donors at-risk. The aim of motivational interviewing was to resolve residual ambivalence associated with the donor’s own decisions about donation. At three months after donation, the intervention group had significantly less physical symptoms, reported a quicker recovery and less anxiety symptoms; there was no difference at six weeks. The intervention group had less depressive symptoms at six weeks, but not at three months. There was no difference in negative feelings about donation. There was no impact on relationship quality with spouse or family, although the intervention group reported fewer unexpected donation-related problems at three months.
Data analysis
Modified intention-to-treat analysis
Trial registration
ClinicalTrials.gov - NCT01233700