Development and validation of the Kidney Transplantation and Quality of Life, a Korean questionnaire to assess the general quality of life and other health issues associated with medication change in kidney transplant recipients

The Determinants of Psychological Well-Being Among Kidney Transplant Recipients in Kazakhstan: A Cross-Sectional Study

Background: Kidney transplantation (KTx) significantly improves survival and quality of life in patients with end-stage renal disease. However, post-transplant well-being is influenced by multiple factors, including healthcare accessibility, satisfaction with medical care, and psychological health. This study aimed to assess the well-being of post-KTx patients in Kazakhstan and examine its associations with healthcare access, satisfaction, and anxiety. Methods: A cross-sectional study was conducted among 223 post-KTx patients in Kazakhstan. Participants were recruited through online surveys and telephone interviews. Only patients who had undergone transplantation within Kazakhstan were included. The WHO-5 Well-Being Index was used to measure well-being, and additional surveys assessed healthcare access, satisfaction with post-KTx care, and treatment-related anxiety. Multiple linear regression was performed to identify predictors of well-being. Results: The mean WHO-5 well-being score was 66.1 (SD = 24.6), indicating moderate well-being. Satisfaction with post-transplant information (β = 0.287, p = 0.015) and educational level (β = 0.172, p = 0.019) were significant positive predictors of well-being. In contrast, post-KTx anxiety (β = -0.154, p = 0.024) and difficulties in accessing medical care (β = -0.216, p = 0.014) negatively affected well-being. Patients residing in rural areas reported greater barriers to post-transplant care compared to those in urban settings (χ2 = 31.6, p = 0.002). Conclusions: Post-KTx well-being in Kazakhstan is influenced by educational level, access to healthcare, satisfaction with medical information, and anxiety levels. Targeted interventions to improve access to post-transplant care, enhance patient education, and address psychological distress may help improve outcomes for post-KTx patients.

Self-Management of Kidney Transplant Recipients Research: A Comprehensive Bibliometric Analysis

Objective

This study analyzes research trends in self-management among kidney transplant recipients to inform future directions.

Methods

Bibliometric analysis was performed on 444 English articles related to self-management of kidney transplant recipients in the Core Collection of Web of Science and Scopus databases using COOC 12.8, R software, Microsoft Excel 2019, VOSviewer, and CiteSpace, with a focus on citation ranking, publication year, journal, country, organization, author, impact factor, and keywords.

Results

Four hundred and forty-four English articles revealed the United States as the leading publisher on kidney transplant recipient self-management. Norway's University of Oslo was the most productive institution, with Mirjam Tielen as the most prolific author and SCHÄFER-KELLER as the most influential. Belgium's research was most cited. Emerging hotspots included medication adherence, quality of life, psychological aspects, telemedicine, and health literacy in self-management research.

Conclusion

This study has identified the most influential articles concerning the self-management of kidney transplant recipients, documented the pivotal journals in the field, and noted the most prolific countries, organizations, and authors contributing to the literature, as well as highlighted upcoming research trends. Going forward, the research in kidney transplant recipient self-management should explore the full potential of interdisciplinary integration, particularly by incorporating telemedicine into self-management education. Future efforts should also be directed towards refining the existing post-transplant follow-up management systems and enhancing lifelong care for kidney transplant recipients. Concurrently, there is a need to improve health literacy and self-management capabilities among these patients, with the ultimate goal of improving their prognosis.

Assessing quality of life in solid organ transplant recipients: A systematic review of the development, content, and quality of available condition- and transplant-specific patient-reported outcome measures

PURPOSE

We aimed to identify the condition- and transplant-specific patient-reported outcome measures (PROMs) available to measure quality of life (QoL) in solid organ transplant (SOT) recipients, examine their development and content, and critically appraise the quality of their measurement properties, to inform recommendations for clinical and research use.

METHODS

We systematically searched MEDLINE, Embase, CINAHL, PsycINFO, Cochrane CENTRAL, and Scopus from inception to 27th January 2023. Search hits were screened for eligibility by two independent reviewers; papers reporting the development and/or validation of condition- and transplant-specific PROMs measuring QoL in adult SOT recipients were considered eligible. We abstracted and synthesised data on PROM characteristics, development (item generation and/or reduction), and content (QoL dimensions). Quality appraisal and synthesis were informed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, and included methodological and quality assessment of measurement properties, GRADE levels of evidence, feasibility and interpretability.

RESULTS

We identified 33 papers reporting 26 QoL PROMs validated in SOT recipients (kidney n = 10 PROMs; liver n = 6; lung n = 3; heart n = 2; pancreas n = 1; multiple organs n = 4). Patient discussions (n = 17 PROMs) and factor analysis (n = 11) were the most common item generation and reduction techniques used, respectively. All PROMs measured ≥3 of nine QoL dimensions (all measured emotional functioning); KDQoL-SF and NIDDK-QA measured all nine. Methodological quality was variable; no PROM had low evidence or better for all measurement properties. All PROMs were COSMIN recommendation category 'B', primarily because none had sufficient content validity.

CONCLUSIONS

There are many condition- and transplant-specific QoL PROMs validated in SOT recipients, particularly kidney. These findings can help inform PROM selection for clinicians and researchers. However, caution is required when adopting measures, due to the substantial heterogeneity in development, content, and quality. Each PROM has potential but requires further research to be recommendable. Greater consideration of patient and professional involvement in PROM development in this setting is needed to ensure sufficient content validity.