title: Prevention of poor psychosocial outcomes in living organ donors: from description to theory-driven intervention development and initial feasibility testing.
abstract: BACKGROUND
  Although some living donors experience psychological, somatic, and interpersonal difficulties after donation, interventions to prevent such outcomes have not been developed or evaluated.
  
  
  OBJECTIVE
  To (1) summarize empirical evidence on psychosocial outcomes after donation, (2) describe a theoretical framework to guide development of an intervention to prevent poor outcomes, and (3) describe development and initial evaluation of feasibility and acceptability of the intervention.
  
  
  METHODS
  Based on a narrative literature review suggesting that individuals ambivalent about donation are at risk for poor psychosocial outcomes after donation, the intervention targeted this risk factor. Intervention structure and content drew on motivational interviewing principles in order to assist prospective donors to resolve ambivalence. Data were collected on donors' characteristics at our institution to determine whether they constituted a representative population in which to evaluate the intervention. Study participants were then recruited to assess the feasibility and acceptability of the intervention. They were required to have scores greater than 0 on the Simmons Ambivalence Scale (indicating at least some ambivalence about donation).
  
  
  RESULTS
  Our population was similar to the national living donor population on most demographic and donation-related characteristics. Eight individuals who had been approved to donate either a kidney or liver segment were enrolled for pilot testing of the intervention. All successfully completed the 2-session telephone-based intervention before scheduled donation surgery. Participants' ratings of acceptability and satisfaction were high. Open-ended comments indicated that the intervention addressed participants' thoughts and concerns about the decision to donate.
  
  
  CONCLUSIONS
  The intervention is feasible, acceptable, and appears relevant to donor concerns. A clinical trial to evaluate the efficacy of the intervention is warranted.
authors.affiliation: University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania 15213, USA. dewma@upmc.edu
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Allan
authors.initials: A
authors.lastname: Zuckoff
authors.forename: Andrea F
authors.initials: AF
authors.lastname: DiMartini
authors.forename: Annette J
authors.initials: AJ
authors.lastname: DeVito Dabbs
authors.forename: Mary L
authors.initials: ML
authors.lastname: McNulty
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Fox
authors.forename: Galen E
authors.initials: GE
authors.lastname: Switzer
authors.forename: Abhinav
authors.initials: A
authors.lastname: Humar
authors.forename: Henkie P
authors.initials: HP
authors.lastname: Tan
mesh_terms: D000328:Adult; D003657:Decision Making; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019520:Living Donors / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000517:prevention & control*; D008603:Mental Health; D008875:Middle Aged; D011795:Surveys and Questionnaires