The Effects of Psychosocial Factors and Coping Strategies on Health-Related Quality of Life of Renal Transplant Recipients.

Abstract

Purpose: This study examined the effects of psychosocial factors and behaviors correlated to three major coping strategies on health-related quality of life (HRQOL) of renal transplant recipients in a theoretically derived model. Background: Some researches have examined impact of coping strategies applied by renal transplant recipients on their HRQOL. However, the relationship among perceived self-efficacy, perceived social support,cognitive appraisal of health, coping strategies and HRQOL in renal transplant recipients using a theoretically derived model have been seldom reported. Methods: Renal transplant recipients with functional kidney graft and more than 3 months after transplantation were recruited from August 1, 2013 to January 30, 2014 at a transplant center clinic. Standardized instruments were used to evaluate the cognitive appraisal of health, perceived self-efficacy, perceived social support, andcoping strategies. HRQOL was measured using SF-36 (vs2). Data were analyzed using IBM SPSS Amos 21.0. Path analysis was used to examine the effects of psychosocial factors and coping strategies on HRQOL of renal transplant recipients. Results: Of the 202(male=126, female=76) recruited recipients, the response rate was 96%. Mean PCS and MCS score was 47.61 (SD=6.75) and 48.18 (SD=9.67), respectively. Path analysis demonstrated that perceived self-efficacy had a significant direct effect on cognitive appraisal of health and HRQOL, and had both direct and indirect effects through primary appraisal on three major coping strategies. Perceived social support had a direct effect on threat primary appraisal, and indirect effect through threat primary appraisal on surrender coping. Results also indicated that primary appraisal of health had a significant direct effect on coping strategies, physical and mental HRQOL. The findings suggested that confrontation and surrender coping strategies had significant direct effects on physical HRQOL, whilst surrender, avoidance and confrontation coping strategies had significant direct effects on mental HRQOL. Conclusion: Health-related quality of life of renal transplant recipients is influenced by a comprehensive interaction among psychosocial factors and coping strategies. More factors should be considered to improve the HRQOL of renal transplant recipients.