Zachciał Justyna, Uchmanowicz Izabella, Czapla Michał, Krajewska Magdalena, Banasik Mirosław
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland.
Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland.
J Clin Med. 2022 Apr 24;11(9):2386. doi: 10.3390/jcm11092386.
Renal transplantation (RT) is the optimal renal replacement treatment approach in terms of patient survival and high quality of life. Proper adherence to medication is essential in order to prolong graft life and patient survival. This study aimed to investigate the effects of psychosocial factors and age-related declines on adherence in kidney transplant recipients. Methods: This was a cross-sectional study of kidney transplant recipients, based on regression analysis. Patient adherence was assessed with the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS). Psychosocial and age-related variables were measured with the World Health Organization’s quality of life questionnaire (WHOQoL-BREF), the Mini-Mental State Examination (MMSE), the Hospital Anxiety and Depression Scale (HADS), the Acceptance of Illness Scale (AIS), and the Tilburg Frailty Indicator (TFI). Results: A simple linear regression model indicated that the significant predictors of self-reported adherence (p < 0.05) were age, time since transplant, and anxiety and cognitive functions. For problems with implementing immunosuppressive medication, logistic regression models showed that gender, age, retirement status, hypercholesterolemia, and cognitive impairment were the most significant predictors (p < 0.05). However, after controlling for other predictors in the multiple regression models, anxiety and cognitive ability no longer predicted treatment adherence to immunosuppressive medication. Conclusions: Renal transplantation is the most effective therapy in chronic renal failure patients. Proper adherence to immunosuppressive therapy is critical to prolonging graft and person survival. Our study shows that occupational status more significantly influences adherence to the implementation of treatment in kidney transplant recipients.
就患者生存率和高质量生活而言，肾移植（RT）是最佳的肾脏替代治疗方法。为了延长移植物寿命和患者生存期，正确坚持服药至关重要。本研究旨在调查心理社会因素和与年龄相关的衰退对肾移植受者服药依从性的影响。方法：这是一项基于回归分析的肾移植受者横断面研究。采用免疫抑制药物依从性巴塞尔评估量表（BAASIS）评估患者的依从性。使用世界卫生组织生活质量问卷（WHOQoL-BREF）、简易精神状态检查表（MMSE）、医院焦虑抑郁量表（HADS）、疾病接受量表（AIS）和蒂尔堡衰弱指标（TFI）测量心理社会和与年龄相关的变量。结果：一个简单线性回归模型表明，自我报告的依从性的显著预测因素（p<0.05）是年龄、移植后的时间以及焦虑和认知功能。对于免疫抑制药物服用方面的问题，逻辑回归模型显示，性别、年龄、退休状态、高胆固醇血症和认知障碍是最显著的预测因素（p<0.05）。然而，在多元回归模型中控制了其他预测因素后，焦虑和认知能力不再能预测免疫抑制药物的治疗依从性。结论：肾移植是慢性肾衰竭患者最有效的治疗方法。正确坚持免疫抑制治疗对于延长移植物和患者生存期至关重要。我们的研究表明，职业状态对肾移植受者治疗实施的依从性影响更为显著。
