Self‐efficacy beliefs, locus of control, religiosity and non‐adherence to immunosuppressive medications in kidney transplant patients

Silva, Andresa Nascimento; Moratelli, Lucas; Tavares, Paula Liziero; Marsicano, Elisa de Oliveira; Pinhati, Renata Romanholi; Colugnati, Fernando Antônio Basile; Lucchetti, Giancarlo; Sanders-Pinheiro, Hélady

doi:10.1111/nep.12695

Cited by 42 publications

(44 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Equally, no associations were detected between collateral reports and self-reports [11,34,36], nor between physicians' estimates and the variability of trough levels [11,34]. Some research also recommends combining several measurement methods to increase sensitivity [9,15,34,37]. Overall, there still seems to be some lack of consensus on how exactly measures of NA correlate with each other and which approach is the best.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and concordance of measurement methods to assess non-adherence after renal transplantation - a prospective study

et al. 2020

View full text Add to dashboard Cite

Background: Non-adherence (NA) to immunosuppressants (IS) among renal transplant recipients (RTRs) is associated with higher risk of allograft rejection, graft loss, and mortality. A precise measurement of NA is indispensable, although its prevalence differs greatly depending on the respective measurement methods. The objective of this study was to assess the accuracy and concordance of different measurement methods of NA in patients after renal transplantation. Design and methods: This was a single-center prospective observational study. At baseline (T0), NA was measured via physicians' estimates (PE), self-reports (SR), and tacrolimus trough level variability (CV%) in 78 RTRs. A Visual Analogue Scale (VAS, 0-100%) was applied both for SR and PE. In addition, we used BAASIS© for SR and a 5-point Likert scale for PE. NA was measured prospectively via electronic monitoring (EM, VAICA©) during a three month period. Meanwhile, all participants received phone calls in a two week interval (T1-T6) during which SRs were given. Results: Seventy-eight RTRs participated in our study. At t0, NA rates of 6.4%, 28.6%, and 15.4% were found for PE, SR, and CV%, respectively. No correlation was found between these methods. During the study, the percentages of self-reported and electronically monitored adherence remained high, with a minimum mean of 91.2% for the strictest adherence measure (Timing Adherence ±30 min). Our results revealed a moderate to high association between SR and EM. In contrast to PE and CV%, SR significantly predicted electronically monitored adherence. Overall, a decreasing effect of electronically monitored adherence was found for both taking and timing adherence (±2 h, ±30 min) over the course of the study.

show abstract

Section: Introductionmentioning

confidence: 99%

Accuracy and concordance of measurement methods to assess non-adherence after renal transplantation - a prospective study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…(13)(14)(15) Another study found that after kidney transplantation, spirituality was correlated with adherence to treatment and suggested a possible relationship between these variables. (16) Still, higher religiosity was related with lower behavior risk and better adherence to treatment. (17) To the best of our knowledge, no studies so far have focused on spirituality and evolution of renal function of kidney transplant patients, thereby justifying our research.…”

Section: Introductionmentioning

confidence: 99%

Influência da espiritualidade sobre a função renal em pacientes transplantados renais

et al. 2017

View full text Add to dashboard Cite

Objective: To evaluate influence of spirituality on renal function of kidney transplant patients. Methods: This cross-sectional study included 81 kidney transplant patients who had undergone transplantation between 30 and 60 months previously. Patients were followed up for 12 months. The analysis was carried out in a large public hospital in the countryside of São Paulo, Brazil. Based on the Duke University Religion Index-religiosity and spirituality scale, we divided patients into two groups (spiritualized [n=52] and less spiritualized [n=29]), considering the median spirituality. For statistical analysis, we used inductive tests and analysis with linear mixed models, with a level of significance of 5% (p<0.05). Results: Clinical characteristics, immunosuppression, social support, adherence to drug therapy, quality of life, and depression did not differ between groups. Renal function after 12 months was significantly higher in the spiritualized group from 9 months on. After 12 months, the percentage of patients with creatinine clearance higher than 60 ml/min was 61.5% in the spiritualized group and 34.5% in the less spiritualized group (p=0.02). Multivariate analysis showed that the less spiritualized group had a 4.7 times greater risk [1.4 -16.8] for worsening in renal function (p=0.01). Conclusion: More spiritualized patients had better renal function after 1 year of transplantation. This result was independent of clinical features, social support, and adherence to immunosuppressive therapy. A holistic approach in health with emphasis on spirituality is encouraged. ResumoObjetivo: Avaliar a influência da espiritualidade na função renal de pacientes transplantados renais. Métodos: Estudo transversal, conduzido em um hospital de clínicas, público e de grande porte, situado no interior do Estado de São Paulo, Brasil, que incluiu 81 pacientes transplantados renais, entre 30 dias e 60 meses de pós-transplante, seguidos por 12 meses. Com base na Escala de Religiosidade de DUREL os pacientes foram divididos em dois grupos considerando-se a mediana da espiritualidade, sendo estes o grupo espiritualizado (n=52) e o menos espiritualizado (n=29). Para a análise estatística foram utilizados testes indutivos e a análise de modelos lineares mistos, com nível de significância de 5% (p<0,05). Resultados: As características clínicas, de imunossupressão, apoio social, adesão ao tratamento medicamentoso, qualidade de vida e depressão não apresentaram diferenças entre os grupos. A função renal ao longo de um ano foi significativamente maior no grupo espiritualizado a partir do nono mês. Ao fim de 12 meses, a percentagem de pacientes com clearance de creatinina superior a 60ml/min. foi de 61,5% no grupo espiritualizado e 34,5% no grupo menos espiritualizado (p=0,02). A análise multivariada mostrou que o grupo menos espiritualizado apresentou um risco de 4,7 vezes [1,4 -16,8] maior para pior função renal (p=0,01). Conclusão: Pacientes mais espiritualizados apresentaram melhor função renal no decorrer de um ano de transp...

show abstract

“…No mesmo sentido, as crenças religiosas podem interferir na adesão ao tratamento, pois motivam efeitos que tendem a prejudicar as cognições e os comportamentos dos pacientes [30].…”

Section: Discussionunclassified

Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

Rocha

Figueiredo

Canabarro

et al. 2017

Sci Med

View full text Add to dashboard Cite

Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACT AIMS: To evaluate the characteristics and risk factors related to the adherence to immunosuppressive treatment of renal transplant patients using the self-report method by means of the Basel Assessment of Adherence Scale for Immunosuppressives (BAASIS). METHODS: A prospective cohort study with a quantitative approach was performed at the Nephrology and Transplantation Service of São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, with patients older than 18 years, transplanted from kidneys from deceased or living donors, with a minimum transplant time of three months and a maximum of 12 months. The BAASIS instrument was applied to evaluate adhesion. For statistical analysis, Fisher exact test (Monte Carlo simulation) was used to verify the association between the categorical variables, Student t test for independent sample means and Mann Whitney test in the variables without normality. A p<0.05 was adopted for the results to be considered significant. RESULTS: The sample consisted of 59 patients, 57.6% of whom were male, 79.7% were white, the mean age was 45.8 years, 57.6% had elementary school and 72.9% were catholic. Hemodialysis was the most used method, in 86.4% of patients before transplantation, and the mean time in the waiting list was 19.5 months. After transplantation, the mean time of hospitalization was 17.2 days. The assessment of adherence by BAASIS characterized 83% of patients as non-adherent. The main fact considered as non-adherence was to take the immunosuppressive drugs with more than two hours difference from the prescribed time, at least once a week, in the last four weeks. There was no significant difference when the statistical analysis was performed to compare the adhesion rate among the various categories of the demographic and clinical variables of the patients. CONCLUSIONS: A high rate of patients not adherent to the immunosuppressive treatment was identified, and the change in the schedule of immunosuppressants was the main fact that characterized this behavior. A shorter waiting time in the transplant queue was associated with non-adherence. The other variables, demographic and clinical, were not associated to the classification of adherent or non-adherent.

show abstract

Self‐efficacy beliefs, locus of control, religiosity and non‐adherence to immunosuppressive medications in kidney transplant patients

Cited by 42 publications

References 31 publications

Accuracy and concordance of measurement methods to assess non-adherence after renal transplantation - a prospective study

Accuracy and concordance of measurement methods to assess non-adherence after renal transplantation - a prospective study

Influência da espiritualidade sobre a função renal em pacientes transplantados renais

Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

Contact Info

Product

Resources

About