Effects of clinical factors on psychosocial variables in renal transplant recipients

Title. Effects of clinical factors on psychosocial variables in renal transplant recipients. Aim. This paper is a report of a study investigating the effects of clinical factors (side effects of immunosuppressive medications, transplant-related hospitalizations, donor type, duration of dialysis before transplantation and time post-transplant) on cognitive appraisal of health, perceived self-efficacy, perceived social support, coping and health-related quality of life after renal transplantation. Background. Some clinical factors such as hospitalizations, side effects of medications, donor type and dialysis, which influence the health-related quality of life of renal transplant recipients, have been investigated. However, the effects of these clinical factors on psychosocial variables after renal transplantation have not been well documented. Method. Using a descriptive cross-sectional design, a convenience sample of 160 renal transplant recipients was recruited (N = 55 < 1 year post-transplant; N = 105 1-3 years post-transplant) from May, 2005 to January, 2006. Standardized instruments were used to measure the key constructs. Multivariate analysis of variance was used to examine the effects of clinical factors on the psychosocial outcome measures. Results. Participants reporting more (> 17) immunosuppressive medication-associated side effects appraised their health more negatively, used more disengagement coping, had lower degrees of perceived self-efficacy, and reported lower physical and mental health-related quality of life than those with fewer symptoms (<= 17). Participants less than 1 year post-transplant used more engagement coping, reported higher degrees of perceived self-efficacy and perceived social support than participants in the later period post-transplant. Conclusion. Interventions aimed at alleviating bothersome medication side effects are needed to help these patients cope with transplantation and improve their health-related quality of life.