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Release: Feb. 28, 2000

Open expression of thoughts benefits kidney transplant patients

IOWA CITY, Iowa -- Kidney transplant patients who feel that they can discuss their stressful thoughts and feelings openly with family members report fewer symptoms of depression and anxiety, according to the results of new University of Iowa research. This finding suggests that interventions aimed at helping some pre-transplant patients to express themselves may improve those patients' emotional wellbeing.

"Waiting for an organ transplant is a stressful experience that is associated with symptoms of depression and anxiety, although few studies have looked at psychological adjustment in renal transplant patients," said Alan J. Christensen, a UI associate professor of psychology and primary investigator for the study. "Our study results suggest that an open family environment provides psychological benefits for these patients."

More than 43,300 people in the United States await kidney transplants, according to the United Network for Organ Sharing. The average national waiting time for kidneys is 28 months. Initial inclusion on a transplant list elicits relief and hope, but the long wait for a transplant and the prospect of major surgery often result in negative emotions and stress, say the researchers.

Christensen's study involved 75 patients recruited from the renal transplantation clinic in the Department of Surgery at the University of Iowa Hospitals and Clinics. All of the patients, whose ages ranged from 15 to 74 years, had end-stage renal disease and were on the waiting list to receive a kidney transplant, with an average waiting time of eight months at the time of the study. More than one-third of the participants had experienced a previous kidney failure.

The researchers measured participants' family expressiveness, cohesion, and conflict; level of depression and anxiety; and the frequency of intrusive thoughts and feelings about the possible transplant. Patients who perceived their family environments to be more open to expression of stressful thoughts and feelings reported fewer symptoms of both depression and anxiety, as well as fewer intrusive thoughts about the transplantation process. In addition, the extent to which patients experienced intrusive thoughts about the transplantation was significantly associated with depression and anxiety.

The study results, published in the latest issue of the "Annals of Behavioral Medicine," are consistent with past findings that social and family support and an environment that fosters open discussion of stressful experiences enhance the psychological adjustment of people with chronic and acute medical problems. "Annals of Behavioral Medicine" is the official peer-reviewed publication of the Society of Behavioral Medicine. The research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases. For more information, contact Alan J. Christensen, (319) 335-3396, alan-christensen@uiowa.edu