Journal Information
Vol. 38. Issue. 5.September - October 2018
Pages 459-572
Vol. 38. Issue. 5.September - October 2018
Pages 459-572
Letter to the Editor
DOI: 10.1016/j.nefroe.2018.06.011
Open Access
Empathy assessment in living kidney donors
Evaluación de la empatía en donante vivo de riñón
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Gema Costa-Requenaa,
Corresponding author
costa_gem@gva.es

Corresponding author.
, Francesc J. Moresob, Irina B. Torresb, Gemma Parramonc, Daniel Seronb
a Servicio de Psiquiatría, Hospital Universitari i Politècnic La Fe, Valencia, Spain
b Servicio de Nefrología, Hospital General Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
c Servicio de Psiquiatría, Hospital General Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
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Tables (2)
Table 1. Sociodemographic characteristics of living kidney donors (N=53).
Table 2. Comparison of IRI sub-scales by gender. Percentiles of means differentiated by gender. Correlation of IRI sub-scales with dispositional variables.
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Dear Editor,

Living kidney donation is an eminently prosocial behaviour. Empathy which is the product of cognitive and emotional factors, is a multidimensional motivating factor of prosocial behaviour.1 The objectives of this study were to assess empathic tendency in people who are going to be living kidney donors, and to study the relationship between empathy and other dispositional variables of the donor that might characterise their prosocial behaviour, such as self-esteem, optimism or perceived social support.

We conducted a simple retrospective cross-sectional study from March 2012 to June 2016. A consecutive sample of 58 living kidney donors were assessed in the Nephrology department of Hospital General Universitari Vall d’Hebron. First, the donors were interviewed to explore the basic reasons for donating. Following the interview, they were invited to participate in the study, and its objectives were explained to them. Those who chose to take part signed the consent form. After collecting their sociodemographic data, they were assessed using psychometric tests. The Interpersonal Reactivity Index (IRI),1,2 used to assess empathy, informs about the capacity to understand others and to put oneself in their place based on one's observations and the verbal information received. The test comprises four sub-scales: two cognitive elements, perspective taking (PT) and fantasy (FS), and two emotional elements, empathic concern (EC) and personal distress (PD). The Life Orientation Test-Revised (LOT-R)3 assesses dispositional optimism, referring to the stable belief in having a general expectancy of a positive future. The Rosenberg self-esteem scale4 is an instrument used to assess the personal satisfaction that each person has in him/herself. Duke-UNC5 is a questionnaire that assesses perceived social support.

The statistical tests included a descriptive analysis using measures of central tendency, a Pearson correlation analysis and a comparison of means using non-parametric tests. The analyses were performed using SPSS® version 15 statistical software.

Table 1 shows the sociodemographic characteristics of the study's participants. Given that, in adapting the IRI questionnaire to a Spanish sample, the empathy assessment was differentiated by gender,2 this differentiation was maintained when calculating the percentiles in our sample. Table 2 shows the means and percentiles for each sub-scale of the IRI. There were no significant differences between men and women in the degree of empathy towards organ donation. The percentiles for all IRI sub-scales were higher for men than for women, the most notable difference being with respect to the EC element, which refers to the sentiments of compassion and concern when faced with the discomfort of others. For the PT and PD elements, the values were above the 75th percentile for both men and women.

Table 1.

Sociodemographic characteristics of living kidney donors (N=53).

Age (years)
Mean (SD)  50.47 (11.37) 
Median  51 
Mode  54 
Range  21–74 
  No.  Percentage 
Gender
Male  28  52.8 
Female  25  47.2 
Level of education
Primary  27  50.9 
Secondary  20  37.8 
University education  11.3 
Marital status
Married  41  77.4 
Single  15.1 
Separated/divorced  5.7 
Widowed  1.9 
Occupation
Employed  37  69.8 
Retired  17 
Disabled  1.9 
Unemployed  11.3 
Relationship with the recipient
Spouse  23  43.4 
Sibling  13  24.5 
Child  13.2 
Parent  9.4 
Friend  9.4 
Mental health history
Crossover transplantation  3.8 
Prior renal replacement therapy in the recipient
None  29  54.7 
Haemodialysis  24  45.3 
Table 2.

Comparison of IRI sub-scales by gender. Percentiles of means differentiated by gender. Correlation of IRI sub-scales with dispositional variables.

  Gender  Mean  SD  t  Sig.  Percentiles  ]LOT-RRosenberg scaleDuke-UNC
              r  Sig.  r  Sig.  r  Sig. 
PTMale  18.96  3.79  −0.06  0.94  80             
Female  19.04  4.42      75             
Total  19  4.05        −0.08  0.57  0.06  0.66  0.03  0.81 
FSMale  14.92  4.59  −1.41  0.16  65             
Female  16.86  5.19      50             
Total  15.80  4.92        −0.09  0.50  −0.06  0.68  −0.09  0.53 
ECMale  19.07  5.37  −0.64  0.52  70             
Female  20  4.88      50             
Total  19.49  5.12        −0.18  0.19  −0.15  0.28  −0.14  0.31 
PDMale  15.82  3.86  −0.90  0.36  85             
Female  16.90  4.59      80             
Total  16.30  4.19        −0.15  0.30  −0.15  0.28  −0.12  0.41 

EC: empathic concern; FS: fantasy; IRI: Interpersonal Reactivity Index; LOT-R: Life Orientation Test-Revised; PD: personal discomfort; PT: perspective taking; SD: standard deviation.

Source: Mestre et al.2

Correlations between age and IRI sub-scales were only significant in the negative sense for the FS element (rFS: –0.37, α=0.00; rPT: –23, α=0.09; rEC: –0.08, α=0.55; rPD: –0.13, α=0.36). A relationship between donor and recipient (spouse, sibling, child, friend, parent) also did not affect the various elements of empathic tendency (PT: χ2=1.77, α=0.77; FS: χ2=7.74, α=0.10; EC: χ2=1.65, α=0.79; PD: χ2=3.89, α=0.42). Conversely, comparing whether or not the recipient had started renal replacement therapy prior to transplant, this significantly affected the empathic tendency of the donor for the PD element (PT: t=0.07, α=0.94; FS: t=0.31, α=0.75; EC: t=0.80, α=0.42; PD: t=2.18, α=0.03).

The donors’ mean scores on dispositional variables such as optimism (LOT-R: 23.39; SD: 3.13), self-esteem (Robrg: 33.78; SD: 4.17) and perceived social support (Duke-UNC: 45.18; SD: 6.77) are high. However, the correlations between the IRI scale and these variables are not significant (Table 2).

Our results are in agreement with other studies on living kidney donors, which have not found differences between men and women in their disposition towards donation.6 Moreover, in relation to the empathic disposition towards organ donation, men scored more highly than the general male population, around the 85th percentile. Mapping the type of relationships to empathic tendency did not reveal any significant correlation. Conversely, empathic tendency was affected by the perception of the recipient's suffering,1,2 associated in our study with having started renal replacement therapy prior to transplant.

As in other studies,7 the majority of living donations in our study (96.34%) were to people who maintain emotional ties with the donor, and the donors are fully aware of who their donation is going to.8 Therefore, in the majority of cases living donation is not unconditional, but direct and partial. This has led to debate in the scientific literature regarding the consistency of the concept of altruism when discussing living donation.9,10

Living donors have high scores in dispositional variables such as optimism, self-esteem and perceived social support, but the correlation of empathic tendency with these variables is not significant. We can therefore conclude that empathy refers to a concept with standalone value in organ donation.

The study has limitations that might affect the extrapolation of the results, as it was conducted in a single centre with a small sample size.

Acknowledgements

We would particularly like to thank the participants who completed the questionnaires and shared their concerns and experiences regarding the organ donation process with us.

References
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Guirado Perich L, Oppenheimer Salinas F. Trasplante renal de donante vivo. En: Lorenzo V, López Gómez JM (Eds.), Nefrología al Día. Available from: http://rev.nefro.elsevier.es/es-monografias-nefrologia-dia-articulo-trasplante-renal-donante-vivo-144 [accessed 26.09.16].
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Altruism in organ donation: an unnecessary requirement?.
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Please cite this article as: Costa-Requena G, Moreso FJ, Torres IB, Parramon G, Seron D. Evaluación de la empatía en donante vivo de riñón. Nefrologia. 2018;38:570–572.

Copyright © 2017. Sociedad Española de Nefrología
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