A Center-Based Approach to a Transplant Employment Program

Life and expectations post-kidney transplant: a qualitative analysis of patient responses

BACKGROUND

The effect of a kidney transplant on a recipient extends beyond the restoration of kidney function. However, there is limited qualitative analysis of recipient perspectives on life following transplantation, particularly in the United States. To understand the full patient experience, it is necessary to understand recipient views on life adjustments after kidney transplantation, medical management, and quality of life. This could lead to improvements in recipient care and sense of well-being.

METHODS

We conducted a paper-based survey from March 23 to October 1, 2015 of 476 kidney transplant recipients at the University of Michigan Health System in Ann Arbor, Michigan. We analyzed their open-ended responses using qualitative research methods. This is a companion analysis to a previous quantitative report on the closed-ended responses to that survey.

RESULTS

Common themes relating to changes following transplantation included: improvements in quality of life, a return to normalcy, better health and more energy. Concerns included: duration of graft survival, fears about one day returning to dialysis or needing to undergo another kidney transplant, comorbidities, future quality of life, and the cost and quality of their healthcare. Many recipients were grateful for their transplant, but some were anxious about the burdens transplantation placed on their loved ones.

CONCLUSIONS

While most recipients reported meaningful improvements in health and lifestyle after kidney transplantation, a minority of participants experienced declines in energy or health status. Worries about how long the transplant will function, future health, and cost and quality of healthcare are prevalent. Future research could study the effects of providing additional information, programs, and interventions following transplantation that target these concerns. This may better prepare and support kidney recipients and lead to improvements in the patient experience.

Development of a Web Site for Transplant Patient Education

The Internet is a global communication network used by more than 17.6 million adults as a major source of current health information. Both the number of health-related Web sites and the number of Web users are increasing exponentially as well as reports indicating a growth in the number of persons who access the Internet specifically to retrieve information about organ transplantation. However, few are using this medium for posttransplant educational or psychosocial purposes. Armed with this information, as well as a commitment from the transplant team, we chose to develop a Web-based educational program to facilitate posttransplant care for our transplant recipients. The purpose of this article is to describe the planning, development, and implementation of a Web-based education program for transplant recipients.

The Relationship between the Sick Role and Functional Ability: One Center's Experience

Objective

To determine the impact of the sick role on posttransplant functional ability.

Methods

A convenience sample of 97 kidney transplant recipients (mean age, 45.8 years; SD, 12.8 years; 47% female; 68% African American) participated in this exploratory cross-sectional study. Self-report data were collected during a posttransplant clinic visit via the Response to Illness Questionnaire used to measure sick-role perceptions, the Functional Status Questionnaire used to measure functional ability, and an investigator-developed Demographic Data Sheet used to measure sociodemographic data and comorbidities.

Results

Factor analysis of the Response to Illness Questionnaire yielded 7 distinct factors that accounted for 62.2% of total score variance. Multiple regression analysis indicated a significant relationship between those 7 factors and the 5 factors revealed by the Functional Status Questionnaire. Demographic factors that also correlated with the functional status factors included type of work, gender, age, education, and donor source. Coping with illness and Resentment of illness were the strongest predictors of functional status in this sample. Patients with the strongest coping skills and the least resentment of illness consistently showed more advanced functional abilities.

Conclusions

Results suggest that individuals who have the strongest coping skills and the least resentment toward their illness seem best able to gain strength and reject the sick role as a permanent identity. Health care providers must acknowledge patients' illness perceptions and design interventions focused on optimizing functional ability in vulnerable transplant recipients.

Development of a Web site for transplant patient education

The Internet is a global communication network used by more than 17.6 million adults as a major source of current health information. Both the number of health-related Web sites and the number of Web users are increasing exponentially as well as reports indicating a growth in the number of persons who access the Internet specifically to retrieve information about organ transplantation. However, few are using this medium for posttransplant educational or psychosocial purposes. Armed with this information, as well as a commitment from the transplant team, we chose to develop a Web-based educational program to facilitate posttransplant care for our transplant recipients. The purpose of this article is to describe the planning, development, and implementation of a Web-based education program for transplant recipients.