Context No empirical studies exist to direct nursing interventions for individuals during the long period of waiting for a transplant. Objective To measure the effect of information and support on hope and uncertainty for individuals awaiting cadaveric kidney transplantation. Design Randomized, controlled study. Setting A university-affiliated hospital in the Midwest from 1997 to 1999. Patients Fifty participants awaiting cadaveric kidney transplantation. Interventions The control group received no intervention phone calls or mailings, which was the current standard of care. The treatment group received phone calls and mailings once every month for 6 months. Main Outcome Measures Hope, measured by the Herth Hope Index, and uncertainty, measured by the Mishel's Uncertainty in Illness Scale for Adults, were evaluated at the beginning of the study and 6 months later. Results No statistically significant effect of the nursing intervention was found on hope and uncertainty in this sample (F = 0.5322, P = .81). Hope was found to be negatively related to uncertainty both before ( r = $0.53, P = .0001) and after ( r = $0.59, P = .0001) intervention. No significant change was found between hope before and after intervention, and uncertainty before and after intervention in the treatment group (F = 1.10, P = .40) or the control group. Conclusion The individuals indicated that definite needs were met by the information and support intervention even though the results did not statistically support the effect of the nursing intervention. Conclusions Several conclusions can be drawn from the findings of this study. First, even though the nursing intervention of providing information and support did not have a statistically significant effect on levels of hope and uncertainty in individuals awaiting kidney transplantation, anecdotal reports from the respondents indicated that the phone calls and mailed information were helpful and appreciated. Valuable information, potentially impacting the outcomes of kidney transplantation, was gathered by the researchers and shared with the transplant team. Secondly, levels of hope were relatively high, whereas levels of uncertainty were moderate in this sample of individuals waiting for cadaveric kidney transplantation. Furthermore, in this sample, the average time since diagnosis of ESRD was more than 4 years and the average waiting time was more than 1 year. There may have been a change over time from viewing the waiting experience as a negative experience to a positive opportunity. Thirdly, the finding of a negative relationship between hope and uncertainty provided support to the growing body of knowledge of this association. Finally, time on the waiting list, gender, and marital status were not associated with levels of hope or uncertainty. Generally, the findings of this study are consistent with existing literature and add to the growing body of knowledge related to the midrange theories of hope and uncertainty.
Survey of Attitudes of Hospital Staff to Cadaveric Kidney Transplantation
