The effect of social support ... on ambivalence of living liver donor candidates

[Clark]

http://onlinelibrary.wiley.com/doi/10.1002/lt.23952/abstract

The effect of social support and donation-related concerns on ambivalence of living liver donor candidates
Lai Yun-Chieh MS1, Lee Wei-Chen MD2, Juang Yeong-Yuh MD3, Yen Lee-Lan MPH, ScD Professor4, Weng Li-Chueh RN, PhD Assistant Professor5,* andChou Hsueh Fen RN, PhD Assistant Professor
DOI: 10.1002/lt.23952
Liver Transplantation
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract

Background: Ambivalence in the decision-making process of living liver donors has the potential to result in their experiencing a negative mental status. To promote donor candidates' well being, is important to study the factors related to ambivalence. Thus, the aim of this study was to explore the ambivalence of living liver donor candidates and to investigate the effect of social support and donation-related concerns on their ambivalence.

Methods: A cross-sectional design was used. A total of 100 living liver donor candidates, who underwent pre-operation evaluation from April to October 2009, were recruited for the study. Participants completed a self-administered questionnaire that contained items related to ambivalence, donation-related concerns, and social support.

Results: The mean score for ambivalence was 3.14 (SD = 1., and the median was 3. Only 7% of the study sample reported no ambivalence during the assessment stage. Ambivalence was positively correlated with donation-related concerns (physical concerns, r = 0.39; psychosocial concerns, r = 0.43; financial concerns, r = 0.29) and negatively correlated with social support (r = -0.16 to -0.33). Those with psychosocial concerns had significantly worse ambivalence (β = 0.29, p = 0.031), while social support mitigated ambivalence (β = -0.34, p = 0.01). When intimacy and social support were included in the model, the effect of psychosocial concerns on ambivalence became non-significant (β = 0.24, p = 0.077).

Conclusion: Ambivalence is common among living liver donor candidates, but instrumental social support can mediate the negative effect of donation-related concerns. Recommendations included providing appropriate social support to minimize donation-related concerns and, thus, to reduce the ambivalence of living liver candidates. Liver Transpl , 2014.

[Clark]

There seems to be no acknowledgement of the legitimate reasons for ambivalence among donor candidates, and no sense of urgency to address the causes instead of the reasonable reactions. What a retreat from the advances we seemed to be making with the transplant professionals. Here's another group that just doesn't get it.