Stress and quality of life in the renal transplant patient: a preliminary investigation

Abstract

End-stage renal disease is a chronic condition which reduces the life-span of its victims. At present there is no cure. Renal transplantation, currently the treatment of choice for many patients, is potentially associated with a number of drawbacks: constant risk of rejection, especially during the first six months, the need to comply with a complex regime of medication capable of producing pronounced side-effects and need for ongoing medical supervision. Despite these problems, little research has been undertake with patients following renal transplantation. The aim of the small-scale, exploratory study reported here was to explore patients' perceptions of stress and quality of life at different stages following a first, functioning renal graft: within six months, between one and five years and over five years later (n = 10 in each group). From the results it became apparent that patients had a number of concerns, of which fear of rejection was the most frequently mentioned, followed by stress generated through altered body image (a product of immunosuppressive therapy). Nevertheless, all reported a significant increase in quality of life after transplantation, although improvement was least marked in patients in the intermediate group (1-5 years after surgery) who also experienced most stress. A larger scale study is recommended to increase the validity of findings which clinicians could then use to design patient interventions to enhance quality of care and quality of life.

Stress, coping and adherence to immunosuppressive medications in kidney transplantation: a comparative study

“…2 Even with a well-functioning graft, these individuals continue to be chronic disease patients who are subject to some level of social, physical and emotional limitations, as is the case with dialysis patients. 9,[22][23][24][25] However, differently from our study, most other studies failed to directly assess the frequency of stress.…”

“…Nevertheless, previous studies evaluating stress and kidney transplantation have used other instruments such as scales based on subjective measurement of stressful factors or specific life themes, including those relating to the illness. [22][23][24][25]28 Those scales probably have limited evaluation capacity because they rely on patient memory and do not consider the coping strategies used by patients, which may alter the stress results. 35 Additionally, we did not find any studies that have shown any consistent link between the specific phases of stress and nonadaptive behavior of nonadherence in cases of kidney transplantation.…”

“…[22][23][24][25][26][27][28] Many challenges are faced after kidney transplantation, such as following a complex medication regimen, dealing with its side effects, living constantly under the influence of feelings of uncertainty or fear relating to graft survival, and the social pressure to return to the previous routine. [22][23][24][25][26][27][28] Another important aspect in this complex interaction is how patients cope with their condition. Coping refers to a set of cognitive and behavioral efforts aimed at controlling, reducing or eliminating stress.…”

Adverse Reactions of Immunosuppressive Drugs in Iranian Adult Kidney Transplant Recipients

“…64 We found no statistically significant association between the number of detected ADRs and immunosuppressive regimens with or without mycophenolate mofetil (P = .629). Inasmuch as the number of patients who developed nausea and vomiting, diarrhea, nephrotoxicity, hepatotoxicity, or thrombocytopenia was limited in the current survey (9,8,6,5, and 4 subjects), comparing the effect of different immunosuppressive regimens on the prevalence of these ADRs was not statistically feasible.…”

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“…14 Likewise, severe adverse effects of immunosuppressive therapy are known to affect treatment compliance, which in turn adversely affects the patients' physical and psychological well-being. 15 Studies based on the theory of stress and response have shown that the adverse effects of immunosuppressive treatment and economic hardships are major stressors for kidney transplant recipients, 16,17 and severely affected patients are likely to adopt negative coping mechanisms. 18 In this cross-sectional study, we assessed the health-related quality of life of living-donor kidney transplant recipients and examined the response of patients to various stressors.…”