Adolescent Experiences Following Organ Transplantation: A Systematic Review of Qualitative Studies
Received 9 December 2008; received in revised form 2 March 2009; accepted 3 April 2009. published online 25 June 2009.
Objective
To describe the experiences of adolescents who underwent organ transplantation.
Study design
We conducted a systematic review of qualitative studies that explored the experiences of adolescents who underwent organ transplantation. We searched 5 electronic databases (to week 3 of July 2008) and reference lists of relevant articles.
Results
Eighteen articles reporting the experiences of 313 adolescent organ transplant recipients were included. Five major themes were identified: (1) redefining identity (seeking normality, anxiety and disappointment, adopting a positive attitude, desiring independence); (2) family functioning (parental overprotection, sibling support); (3) social adjustment (support networks, peer rejection, maintaining schoolwork, participation in physical activities); (4) managing medical demands (assuming responsibility, dependence on caregivers, disruption to lifestyle, vigilant adherence, pain and discomfort); and (5) attitude toward the donor (obligation of gratitude, strengthened relationship, concerns about risks to donor).
Conclusions
Although transplantation offers adolescents a better chance of survival and increased freedom and energy, it poses many challenges. A multifaceted response is needed to equip adolescent transplant recipients with skills and capacities to help them achieve a sense of normality, cope with fear of death and organ rejection, gain acceptance among their peers, build confidence in learning, and resolve relationship tensions with the living donor.
aCentre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
bSchool of Public Health, University of Sydney, Sydney, NSW 2006, Australia
Reprint requests: Allison Tong, The Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
Supported by in part by a postdoctoral research fellowship funded under the National Health and Medical Research Council Capacity Building Grant in Population Health (ID 457281, to A.T.). The authors declare no conflicts of interest.
ABSTRACT