Description of the experience lived by the kidney transplanted patient to improve long-term nursing care. Analysis of the literature

Abstract

Introduction: Renal transplantation is the best treatment for most patients with chronic renal failure at an advanced stage. In recent years, in response to the reduced availability of organs, the eligibility criteria for donation have been expanted and living donor transplantation was implemented, too. Transplant system complexity and problems occurring after transplantation require a greater expertise in clinical care. The analysis of transplant patient's experience is important for the identification of patient's needs and for the prevention of complications. Materials and methods: Research studies last 15 years through databases Pubmed and CINAHL. Search through institutional websites is useful for statistical data and legal references. Results: 17 items have been selected on the quality of life and transplant patient's experience. A critical analysis of the content has been made through a division into five thematic areas: organ donation, legal nursing skills, psycho-social and relational components, clinical care components, outcome data. Conclusions: The pathway to an optimal health state after the transplant is long and sometimes hampered by complications such as rejection, infections, cancers and disorders of the psychic sphere. The problems that occur gradually over time are the reconstruction of the image of the self and of the identity, the concerns about the origins of the kidney, the management of complications, the adherence to therapy and the relationship with the family and any living donor. For a proper long-term plan a stronger nursing role in decision-making together with a well organized outpatient follow-up service is of great importance, supported by a multidisciplinary team for specific complications (adherence to the requirements: diet, therapy, hygiene).