van der Mei Sijrike F, van Son Willem J, van Sonderen Eric L P, de Jong Paul E, Groothoff Johan W, van den Heuvel Wim J A
Northern Center for Healthcare Research, University Medical Center Groningen, University of Groningen, the Netherlands.
Transplantation. 2007 Sep 27;84(6):729-37. doi: 10.1097/01.tp.0000281409.35702.53.
This study describes changes in social participation in the first year after kidney transplantation and examines the influence of clinical factors, health status, transplantation-related symptoms, and psychological characteristics on change in social participation.
A prospective study was performed on a cohort of primary kidney transplant recipients, transplanted between March 2002 and March 2003. Data on participation in obligatory activities (i.e., employment, education, household tasks) and leisure activities (i.e., volunteer work, assisting others, sports, clubs/associations, recreation, socializing, going out) were collected by in-home interviews (n=61) at 3 months (T1) and 1 year posttransplantation (T2). Analysis of covariance was performed.
Data showed an increase in participation in obligatory activities and diversity of leisure participation between T1 and T2, although pre-end-stage renal disease level was not regained and differed from the general population. On T1, the majority of employed recipients were on sick leave, but returned to work on T2. Employment rate remained stable. An increase in obligatory participation was predicted by clinical factors (i.e., peritoneal dialysis, initial hospitalization), whereas change in leisure participation was related to serum albumin and cognitive capacity. No effects were found for type of donation, comorbidity, and renal function.
We found that mainly clinical factors were associated with an increase in participation in society. Although health-status related factors and the psychological attribute self-efficacy may be related to recovery of social participation, their effect was outweighed by the strength of clinical predictors in multivariate analysis.
本研究描述了肾移植后第一年社会参与情况的变化，并探讨了临床因素、健康状况、移植相关症状及心理特征对社会参与变化的影响。
对2002年3月至2003年3月间接受初次肾移植的一组受者进行前瞻性研究。通过移植后3个月（T1）和1年（T2）时的入户访谈（n = 61）收集有关参与义务活动（即就业、教育、家务）和休闲活动（即志愿工作、帮助他人、运动、俱乐部/协会、娱乐、社交、外出）的数据。进行协方差分析。
数据显示，T1至T2期间义务活动参与度增加，休闲参与的多样性增加，尽管未恢复到终末期肾病前期水平且与一般人群不同。在T1时，大多数就业受者休病假，但在T2时重返工作岗位。就业率保持稳定。临床因素（即腹膜透析、初次住院）可预测义务参与度的增加，而休闲参与度的变化与血清白蛋白和认知能力有关。未发现捐赠类型、合并症和肾功能的影响。
我们发现主要是临床因素与社会参与度的增加相关。尽管与健康状况相关的因素和心理属性自我效能可能与社会参与的恢复有关，但在多变量分析中，它们的影响被临床预测因素的强度所抵消。
