A psychological intervention to improve quality of life and reduce psychological distress in adults awaiting kidney transplantation

Abstract

Background: Adults with end-stage renal disease who are awaiting kidney transplantation are at risk for low quality of life, high psychological disturbance and relationship distress. Effective psychological interventions to improve functioning in these areas are lacking.

Methods: Sixty-two adults approved for kidney transplantation at one centre in the USA were randomized to quality of life therapy (QOLT), supportive therapy (ST) or standard care (SC) with repeated assessments of quality of life, psychological distress, and social intimacy at pre-intervention (T1), 1 week post-intervention (T2) and 12-week follow-up (T3).

Results: QOLT patients had higher quality of life scores than ST and SC patients at T2 and T3, and higher social intimacy scores compared with SC patients at T3. Both QOLT and ST patients had lower psychological distress scores compared with SC patients at T2, although only QOLT continued to show reductions in psychological distress scores relative to SC patients at T3.

Conclusions: The findings show that it is possible to improve quality of life, psychological functioning and social intimacy with QOLT while patients await kidney transplantation. Study limitations include small sample size, single-centre study and possible patient self-selection biases. Future research will examine whether QOLT effectiveness is affected by treatment modality (face-to-face vs. telephone) and timing (pre- vs. post-transplantation).

Fig. 1

CONSORT diagram showing patient progression through the study.