Psychologische Betreuung im Zusammenhang mit der Nierenspende – Entwicklung des Heidelberger Beratungskonzepts von 1997 bis 2005

Subtitle: Psychological counselling in living kidney donation – Concept development in Heidelberg from 1997 until 2005

Article type: Research Article

Authors: Schweitzer, Jochen | Seidel-Wiesel, Maria

Affiliations: Zentrum für Psychosoziale Medizin, Institut für Medizinische Psychologie, Bergheimer Straße 20, 69115 Heidelberg. Tel.: 06221/56 8150 1; Fax: 06221/56 5303; E-mail: Jochen_Schweitzer-Rothers@med.uni-heidelberg.de

Abstract: Background: Psychological counselling and evaluation of transplantation patients and their living donors is dealt with very differently at the different transplantation centres. At Heidelberg University Hospital, counselling provided by the Medical Psychology department in collaboration with the transplantation center started in 1997 and has developed constantly until 2005, when this counselling became an internal task of the transplantation center. This article summarizes the ongoing development of our counselling approach during this period, triggered by continuous research from 2001 on. Methods: From June 2001 to February 2002, we carried out a first evaluation of our counselling interviews with 33 donor-recipient pairs. Since June 2002 we carry out continuous follow-ups one year after living donor kidney transplantation. Results: In many cases participants were sceptical to indifferent about preparatory medical-psychological counselling. The need for either drastic or extremely sensitive information varied and frequently acquired a new meaning in retrospect depending on the outcome of the transplantation. During the hospital stay, many patients experienced short-term, severe distress they usually coped with on their own but would have liked the offer of psychological relief. A long time after the operation there was only a small number of recipients or donors who did express a wish for psychological support. Conclusions: Based on the results, we were able to draw up further proposals for an optimum care concept for kidney transplantation patients from living donors. Our medical-psychological counselling spectrum as of 2005 covers the preoperative, in-patient and postoperative phase and is currently accompanied by a one-year follow-up. However, readiness to engage in intensive pre-operative psychological reflexion may decrease, as living donor kidney tranplantation is becoming a routine operation to be delivered in great numbers.

Keywords: Psychological counselling, living donor, kidney transplantation

Journal: Zeitschrift für Medizinische Psychologie, vol. 17, no. 1, pp. 19-22, 2008