Effect of Patient Coping Preferences on Quality of Life Following Renal Transplantation

Wednesday, 9 July 2008: 8:50 AM
Ciara White, MSc, RN , Renal, Beaumont Hospital, Dublin, Ireland

Learning Objective 1: critically discuss the complex relationships that exist between quality of life and coping preferences in the post renal transplant population.

Learning Objective 2: evaluate the predictors of renal transplant recipients’ quality of life to enable the targeting of effective interventions by nurses to enhance quality of care.

Purpose: Authors of quality of life (QOL) research have highlighted the need to identify individual difference factors that influence patient QOL gains following renal transplantation. The aim of the study was to investigate the research hypothesis which states that QOL following renal transplantation varies as a function of patient coping preferences, with patients who have more active coping strategies displaying a higher QOL than those who use coping strategies such as avoidance.

Method: This quantitative study which utilised a correlational design, was conducted in the national referral centre for renal transplantation in Ireland and the study sample comprised of 172 transplant recipients. Data was collected using a self-administered questionnaire containing 89 items which was comprised of a demographics and clinical variables section and three standardised scales to assess recipients' QOL and coping styles; WHOQOL-BREF, the Krantz Health Opinion Survey and the Coping Strategy Indicator. Data was analysed using a number of statistical tests including Pearson's r correlations, t-tests and one way ANOVAs.

Results: The patient sample perceived that they had a good QOL, scoring highly on each of the four domains measured by the WHOQOL-BREF. The recipients utilised more problem solving coping strategies than avoidance coping styles. Avoidance coping styles were associated with significantly lower QOL following transplantation, but more active coping styles were not significantly related to higher QOL scores. A number of the demographic and clinical variables explored were found to have a significant impact upon recipients' QOL and choice of coping strategy.

Conclusions: The study findings suggest that avoidance coping strategies such as withdrawal and distraction have a distinctly negative impact upon a transplant patient's QOL. Assessment of coping strategies among the renal transplant population should be further explored in clinical practice and strategies employed to promote positive coping strategies to increase recipients' QOL gains post transplant.