Living with a new kidney from the perspective of adolescents: A mandala-supported qualitative study

Background: Despite advances in transplant procedures, children and adolescents still face some challenges post-transplant and are at high risk for psychiatric, academic, and social problems. This study aims to explore the lived experiences of adolescent kidney transplant recipients through interviews and the use of mandala art therapy.

Methods: This study adopted a descriptive phenomenological design and thematic analysis approach based on Husserl's philosophy. The sample included kidney transplant recipients aged 12-18 years admitted to the pediatric nephrology polyclinic of a university hospital in southern Türkiye. Data were collected through in-depth interviews conducted during a mandala art activity with 14 adolescent kidney transplant recipients. The qualitative data were analyzed using Colaizzi's seven-stage qualitative analysis method, which is suitable to the descriptive phenomenological design employed in the present study.

Results: Four themes and seven subthemes emerged from the data related to the problems and experiences of adolescents with kidney transplantation and growing up with a new kidney. (1) Education, (2) Ideas about the kidney; including the sub-themes "What the kidney transplant process gave them, Feelings about their kidneys", (3) Family; including the sub-themes "Relationship with the donor, Relationship with siblings", (4) Social environment; including the sub-themes "Experiences with hospital, Relationship with friends and Desire for friendship with a transplanted Peer".

Conclusion: Mandala art therapy-assisted interviews are an effective communication method for adolescent kidney transplant recipients to express their feelings and thoughts and to look at life from a broader perspective. Understanding the life experiences of adolescents with kidney transplantation and the difficulties they face may enable better and more systematic planning of the care to be given to them.