A psychological intervention to improve quality of life and reduce psychological distress in adults awaiting kidney transplantation.
BACKGROUND
Adults with end-stage renal disease who are awaiting kidney transplantation are at risk for low quality of life, high psychological disturbance and relationship distress. Effective psychological interventions to improve functioning in these areas are lacking.


METHODS
Sixty-two adults approved for kidney transplantation at one centre in the USA were randomized to quality of life therapy (QOLT), supportive therapy (ST) or standard care (SC) with repeated assessments of quality of life, psychological distress, and social intimacy at pre-intervention (T1), 1 week post-intervention (T2) and 12-week follow-up (T3).


RESULTS
QOLT patients had higher quality of life scores than ST and SC patients at T2 and T3, and higher social intimacy scores compared with SC patients at T3. Both QOLT and ST patients had lower psychological distress scores compared with SC patients at T2, although only QOLT continued to show reductions in psychological distress scores relative to SC patients at T3.


CONCLUSIONS
The findings show that it is possible to improve quality of life, psychological functioning and social intimacy with QOLT while patients await kidney transplantation. Study limitations include small sample size, single-centre study and possible patient self-selection biases. Future research will examine whether QOLT effectiveness is affected by treatment modality (face-to-face vs. telephone) and timing (pre- vs. post-transplantation).
Rodrigue
James R
JR
Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA. jrrodrig@bidmc.harvard.edu
Mandelbrot
Didier A
DA
Pavlakis
Martha
M
D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological / Q000628:therapy*; D014850:Waiting Lists