Factors Affecting Anxiety of Kidney Transplant Recipients According to Donor Type: A Descriptive Study

Published:August 27, 2022DOI:



      High anxiety among kidney transplant recipients has negative psychosocial consequences for health quality. This study aims to determine the risk factors that affect levels of anxiety in recipients of kidney transplants according to living and deceased donor types.


      The study was conducted using a descriptive correlational research method.


      The study conducted research with 330 kidney transplant recipients (from 261 live and 69 cadaver donors) who agreed to participate between February and July 2019. Participants completed the State-Trait Anxiety Inventory, which assesses state and trait anxiety.


      Participants had low state anxiety and moderate trait anxiety scores. A statistically significant, positive, moderate correlation was found between state anxiety scale and trait anxiety scale mean scores of recipients of kidney transplants from both living and deceased donors. According to a regression analysis of trait anxiety scores of transplant recipients from living donors, positive independent risk factors for anxiety include kidney transplant recipients with a low income, receiving kidneys from male donors, drug noncompliance, sleep disorders, and mental problems.


      Both kidney transplant recipients from living and deceased donors had low state anxiety and moderate trait anxiety. Nurses should develop effective intervention strategies that continue throughout life to reduce the anxiety of kidney transplant recipients.


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        • Fleming G
        • Thomson EM.
        Organ donation and management of the potential organ donor.
        Intensive Care Med. 2021; 22: 315-320
      1. The Global Database on Donation and Transplantation GODT 2018,; 2021. Accessed February 25, 2021.

        • Brito DcSd
        • Machado EL
        • Reis IA
        • Carmo LpdFd
        • Cherchiglia ML.
        Depression and anxiety among patients undergoing dialysis and kidney transplantation: a cross-sectional study.
        Sao Paulo Med J. 2019; 137: 137-147
        • Tamura Y
        • Urawa A
        • Watanabe S
        • et al.
        Mood status and quality of life in kidney recipients after transplantation.
        Transplant Proc. 2018; 50: 2521-2525
        • Suzuki R
        • Nakamiya Y
        • Watanabe M
        • et al.
        Relationship between stress coping mechanisms and depression in kidney transplant recipients.
        Transplant Proc. 2019; 51: 761-767
        • McAdams-DeMarco MA
        • Olorundare IO
        • Ying H
        • et al.
        Frailty and postkidney transplant health-related quality of life.
        Transplantation. 2018; 102: 291-299
        • Naqvi R.
        Evaluation of psychiatric issues in renal transplant setting.
        Indian J Nephrol. 2015; 25: 321-325
        • Tarabeih M
        • Bokek-Cohen Y
        • Azuri P.
        Health-related quality of life of transplant recipients: a comparison between lung, kidney, heart, and liver recipients.
        Qual Life Res. 2020; 29: 1631-1639
      2. American Psychological Association. Recommends, ; 2020. Accessed May18, 2020.

        • Spielberger CD.
        State-trait anxiety inventory. The Corsini encyclopedia of psychology. 10. John Wiley & Sons, Inc, Hoboken, NJ2010: 9-15
        • Oner N
        • Le Compte A.
        State/trait anxiety inventory handbook.
        2nd ed. Boğaziçi University, Istanbul1985: 1-7
        • Spielberger CD
        • Reheiser EC.
        Assessment of emotions: Anxiety, anger, depression, and curiosity.
        Appl Psychol Health Well Being. 2009; 1: 271-302
        • Lai YL
        • Neo HLM
        • Vathsala A
        • Griva K.
        Comparing emotional adjustment of living-donor and deceased-donor kidney transplant patients.
        Transplant Direct. 2020; 6: 1-6
        • Zimmermann T
        • Pabst S
        • Bertram A
        • Schiffer M
        • De Zwaan M.
        Differences in emotional responses in living and deceased donor kidney transplant patients.
        Clin Kidney J. 2016; 9: 503-509
        • De Pasquale C
        • Pistorio ML
        • Veroux M
        • et al.
        Nonverbal communication and psychopathology in kidney transplant recipients.
        Transplant Proc. 2019; 51: 2931-2935
        • van Sandwijk MS
        • Al Arashi D
        • van de Hare FM
        • et al.
        Fatigue, anxiety, depression and quality of life in kidney transplant recipients, haemodialysis patients, patients with a haematological malignancy and healthy controls.
        Nephrol Dial Transplant. 2019; 34: 833-838
        • Müller HH
        • Lücke C
        • Englbrecht M
        • et al.
        Kidney-transplant patients receiving living-or dead-donor organs have similar psychological outcomes (findings from the PI-KT study).
        Ment Illn. 2020; 12: 17-22
        • Spiers J
        • Smith JA.
        Waiting for a kidney from a deceased donor: an interpretative phenomenological analysis.
        Psychol Health Med. 2016; 21: 836-844
        • Lonargáin DÓ
        • Brannigan D
        • Murray C.
        The experience of receiving a kidney transplant from a deceased donor: implications for renal services.
        Psychol Health. 2017; 32: 204-220
        • Latos M
        • Lázár G
        • Horváth Z
        • et al.
        Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients.
        Transplant Res Risk Manag. 2016; 8: 15-24
        • De Pasquale C
        • Pistorio ML
        • Veroux M
        • et al.
        Psychological and psychopathological aspects of kidney transplantation: a systematic review.
        Front Psychiatry. 2020; 11: 1-25
        • Dew MA
        • Rosenberger EM
        • Myaskovsky L
        • et al.
        Depression and anxiety as risk factors for morbidity and mortality after organ transplantation: a systematic review and meta-analysis.
        Transplantation. 2015; 100 (2015): 988-1003
        • Kim I-K
        • Bae S
        • Son S
        • Kim M
        • Jun S
        • Ju M.
        Health-related quality of life and psychologic distress in Korean kidney transplant recipients.
        Transplant Proc. 2016; 48: 855-857
        • Ergun G.
        Evaluation the depression and anxiety levels of individuals in the process of kidney transplantation provided by Peplau’s supportive health counseling service.
        Hemşirelikte Araştırma Geliştirme Dergisi. 2017; 19: 41-56
        • De Pasquale C
        • Veroux M
        • Pistorio M
        • Papotto A
        • Basile G
        • Patanè M.
        Return to work and quality of life: a psychosocial survey after kidney transplant.
        Transplant Proc. 2019; 51: 153-156
        • Maple H
        • Chilcot J
        • Weinman J
        • Mamode N.
        Psychosocial wellbeing after living kidney donation–a longitudinal, prospective study.
        Transpl Int. 2017; 30: 987-1001
        • Spielberger CD
        • Jacobs G
        • Russell S
        • Crane RS.
        Assessment of anger: the state-trait anger scale.
        Adv Personal Assess. 1983; 2: 159-187
        • Gross CR
        • Reilly-Spong M
        • Park T
        • Zhao R
        • Gurvich OV
        • Ibrahim HN.
        Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation.
        Contemp Clin Trials. 2017; 57: 37-43
        • Wesolowska-Gorniak K
        • Wojtowicz M
        • Gierus J
        • Czarkowska-Paczek B.
        The correlation of patientsʼ anxiety after a liver or kidney transplantation with functional and self-reported work ability.
        Medicine. 2020; 99: 1-5
        • Booth RW
        • Sharma D
        • Leader TI.
        The age of anxiety? It depends where you look: changes in STAI trait anxiety, 1970–2010.
        Soc Psychiatry Psychiatr Epidemiol. 2016; 51: 193-202
        • Epstein FR
        • Liu CM
        • Stevenson JM.
        Heart transplant recipients prefer a telemental health cognitive-behavioral therapy intervention delivered by telephone.
        Telemed J E Health. 2019; 25: 560-568
        • Li J
        • Li X
        • Jiang J
        • et al.
        The effect of cognitive behavioral therapy on depression, anxiety, and stress in patients with COVID-19: a randomized controlled trial.
        Front Psychiatry. 2020; 11580827
        • Karagozoglu S
        • Tekyasar F
        • Yilmaz FA.
        Effects of music therapy and guided visual imagery on chemotherapy-induced anxiety and nausea-vomiting.
        J Clin Nurs. 2013; 22: 39-50
        • Burgstahler MS
        • Stenson MC.
        Effects of guided mindfulness meditation on anxiety and stress in a pre-healthcare college student population: a pilot study.
        J Am Coll Health. 2020; 68: 666-672
        • Foley T
        • Lanzillotta-Rangeley J.
        Stress reduction through mindfulness meditation in student registered nurse anesthetists.
        AANA journal. 2021; 89: 284-289
        • Soylu D
        • Ortabag T.
        Determination of quality of life after renal transplantation.
        Turk Neph Dial Transpl. 2017; 26: 215-221
        • Noohi S
        • Khaghani-Zadeh M
        • Javadipour M
        • et al.
        Anxiety and depression are correlated with higher morbidity after kidney transplantation.
        Transplant Proc. 2007; 39: 1074-1078
        • Buchberger B
        • Huppertz H
        • Krabbe L
        • Lux B
        • Mattivi JT
        • Siafarikas A.
        Symptoms of depression and anxiety in youth with type 1 diabetes: a systematic review and meta-analysis.
        Psychoneuroendocrinology. 2016; 70: 70-84
        • Batelaan NM
        • Seldenrijk A
        • Bot M
        • van Balkom AJ
        • Penninx BW.
        Anxiety and new onset of cardiovascular disease: critical review and meta-analysis.
        Br J Psychiatry. 2016; 208: 223-231
        • Naicker K
        • Johnson JA
        • Skogen JC
        • et al.
        Type 2 diabetes and comorbid symptoms of depression and anxiety: longitudinal associations with mortality risk.
        Diabetes Care. 2017; 40: 352-358
        • Lam NN
        • Kim SJ
        • Knoll GA
        • et al.
        The risk of cardiovascular disease is not increasing over time despite aging and higher comorbidity burden of kidney transplant recipients.
        Transplantation. 2017; 101: 588-596
        • Mathur AK
        • Chang YH
        • Steidley DE
        • et al.
        Patterns of care and outcomes in cardiovascular disease after kidney transplantation in the United States.
        Transplant Direct. 2017; 3: 1-7
        • Wong G
        • Teixeira-Pinto A
        • Chapman JR
        • Craig JC
        • Pleass H
        • McDonald S.
        The impact of total ischemic time, donor age and the pathway of donor death on graft outcomes after deceased donor kidney transplantation.
        Transplantation. 2017; 101: 1152-1158
        • Reilly-Spong M
        • Park T
        • Gross CR.
        Poor sleep in organ transplant recipients: self-reports and actigraphy.
        Clin Transplant. 2014; 27: 901-913
        • Parajuli S
        • Tiwari R
        • Clark DF
        • Mandelbrot DA
        • Djamali A
        • Casey K.
        Sleep disorders: serious threats among kidney transplant recipients.
        Transplant Rev. 2019; 33: 9-16
        • Yaman Z.
        The relationship between social supports and mental states of individuals with kidney transplantation [Unpublished master thesis].
        University of Mersin, 2016