Stress and stress-related factors of patients after renal transplantation in Taiwan: a cross-sectional study

Abstract

Aims: The aim of this study is to quantify the amount and causes of stress in renal transplant recipients.

Background: After renal transplantation, patients may encounter physical and psychosocial problems. Through patient collaboration with healthcare professionals, treatment after transplantation is aimed at restoring and maintaining a 'normal' life. To achieve quality of life, research needs to quantify the amount and causes of stress of renal transplant recipients, from a patient-centred perspective.

Design: A cross-sectional, descriptive study.

Methods: The study was conducted in the outpatient department of a medical centre in northern Taiwan from September 2005-February 2006. The recipients were a convenience sample of 153 participants who had undergone renal transplantation.

Results: The results showed that renal transplant recipients had low to moderate stress in four areas. Gender (male), self-efficacy and hospitalisation for infection explained 17% of the variance found for the stress of uncertainty; hospitalisation for rejection and infection explained 22% of the variance for complications; and gender (male) and self-efficacy explained 8% of the variance for the interactions with others. Post-transplant time was not found to be a predictor of stress.

Conclusion: After renal transplantation, patients experience multi-dimensional stresses that previous research has not explored. Self-efficacy was shown to be a significant predictor of the stress of uncertainty and interactions with others. Enhancing recipients' self-efficacy of self-care behaviour can lower the stress that found in three areas.

Relevance to clinical practice: Healthcare professionals should develop an evidence-based programme for stress management for renal transplantation patients that incorporates strategies to enhance patient's self-efficacy of self-care behaviour. Recipients' beliefs in their ability to successfully perform self-care behaviour can be promoted by a mastery experience, vicarious experience with other patients, social persuasion and re-explanation of somatic and emotional states by discussing coping methods with healthcare professionals.