Research Awards Recipients

Supervisor(s):  Shaifali Sandal

Lay Abstract

Background and Purpose: Resilience is our ability to bounce back from life’s challenges. What’s important to note is that resilience is not just an innate trait, it is a skill that can be developed and improved. The level of resilience a person has can be measured, and this has been useful in both the field of psychology and medicine.
 
Kidney transplant recipients diagnosed with depression face a daunting reality, they have a significantly higher risk of their transplant failing and mortality. Research has shown that having high psychological resilience is linked with overall well-being. However, there is limited research that examines the concept of resilience in kidney transplantation. This gap presents an opportunity: by assessing resilience, we can better understand patient vulnerabilities and improve care for kidney transplant recipients at high risk of depression. Focusing on resilience could lead to targeted interventions that can improve mental health outcomes which could then potentially decrease the risk of a patient losing their transplant and increase their chances of transplant success and survival. Kidney transplant recipients experience many challenges and adverse events, such as side effects from medications, infections, risk of transplant failure and even mortality. Additionally, mental health illnesses are quite common among them, and a patient’s ability to cope with these challenges is often correlated to their overall health and recovery. Resilience is a skill that helps individuals cope with adversity. It is associated with overall well-being and some emerging research has found it to be associated with positive outcomes after the transplant surgery. We hypothesize that higher levels of resilience are associated with a lower risk of depression in kidney transplant recipients following an adverse event. The study is organized into two main aims: Aim 1, we will review and summarize existing studies on resilience measures within nephrology and kidney transplant literature. Aim 2, we will conduct a single-center study to gather demographic characteristics (i.e. age, race/ethnicity and gender), resilience, mental health, and health outcomes of kidney transplant recipients. We will then compare their resilience levels before and after they experience an adverse event.
 
Methodology and Feasibility: Aim 1: we will conduct a scoping review of the literature, where two independent reviewers will screen, review, and extract data from existing research. We will compile our findings into a manuscript to highlight what we know and what needs to be further studied. Aim 2: We will use the Connor-Davidson Resilience Scale (CD-RISC) to measure psychological resilience in kidney transplant recipients. We will also be measuring quality of life (Medical Outcome Study Short-Form (SF-12V2) Health Survey) and depression severity (Patient Health Questionnaire (PHQ-9)). Each scale has been tested and determined to be reliable. This study will take place for over 12 months at our McGill University Health Centre outpatient clinics that sees over 1,500 kidney transplant recipients annually. With ethics approval, we will recruit patients from the clinics’ waiting area and ask them to complete the scales. Our target is to consent at least 200 kidney transplant recipients, which we believe is achievable given the number of patients at this center. We will also track participants who experience transplant failure or other adverse events and ask them to complete the scales again during the follow-up visit.
 
Patient Engagement: We are working closely with Mr. Robert Buzinski, a patient partner who has helped shape this research approach. We will be meeting with him every three months to discuss the research progress and share findings. After completing my MSc thesis work, I plan to form a patient committee for a future multi-center study. This will allow us to obtain patient’s input on study design and interventions aimed at improving patient resilience.
 
Anticipated Outcomes and Relevance to Patients/Community: We expect to find that kidney transplant recipients with higher resilience will experience fewer depressive symptoms after an adverse event. Additionally, we expect that some psychosocial factors (i.e. gender, age, social support) will influence this relationship. We plan to present our findings at medical conferences to share insights. Dr. Shaifali Sandal, my supervisor, is creating a Supportive Care in Transplantation model to enhance support for kidney transplant recipients. My project aligns with her research by using resilience measures to identify patients who need extra support when facing adverse events. Using a resilience scale offers an inexpensive and simple method in identifying vulnerable patients. Integrating resilience assessments into regular care could help promote patient-centered care, improving overall well-being and health outcomes for patients experiencing kidney loss.