Kidney Transplantation: Investigating Sexual Functioning in Female Recipients and Exploring the Lived Experience of Donors

This thesis explores aspects of kidney transplantation across three papers. A systematic literature review focuses on the sexual functioning of women following kidney transplant (KTx). A review of quantitative studies found that having a KTx improved sexual functioning when compared to other renal replacement therapies. However, as the studies were methodologically flawed it was difficult to conclude how much improvement in sexual functioning is gained. Some studies found sexual functioning was restored and is comparable to general population whereas others found problems continued following KTx. An empirical study explores the lived experience of living non-couple donors. Using interpretative phenomenological analysis, six living donors agreed to share their stories. Three themes evolved from the data which revealed complexities in the decision making process, difficulties regarding loss and adjustment during and following the donation and donors’ minimisation of their difficulties. This appeared to contribute to the donors’ perception of a lack of care and support during their donation. Clinical recommendations include enhancing information and further preparation during the assessment process, access to psychological support and independent advocates and increasing clinician awareness of the barriers that prevent donors sharing any difficulties. A final paper considers the impact of the findings in both research and clinical fields. This paper highlights the lack of good quality research investigating psychological aspects of donating and receiving a kidney. The implications and recommendations for renal services are discussed, focusing on the increased utility of advocacy, psychology involvement and increasing clinicians’ awareness of the emotional impact of donating. In addition, this paper contains personal reflections regarding the research process and findings