Kidney Transplantation Clinical Trial
Official title:
Individual and Dyadic Functioning of Patients and Their Spouses After Kidney Transplantation With Regard to Adherence and Quality of Life
Following solid organ transplantation, adherence to treatment regime (especially with regard
to a reliable intake of immunosuppressant medication) is crucial for transplant survival,
and has an impact on the patients' health and morbidity. Approximately 35 % of graft
rejection or failure cases in kidney transplant patients are due to insufficient levels of
adherence or non-adherence to immunosuppressant medication. Adherence is influenced by both
individual and interpersonal aspects in complex interaction.
This study aims at investigating individual and dyadic functioning of both patients and
their spouses following kidney transplantation. Outcome measures of interest are patient's
level of adherence and both patient and spouse's subjective quality of life.
In Germany, kidney transplant patients form the largest group in solid organ
transplantation. Improvements in diagnosing and treating medical problems and complications
have lead to enhanced survival rates after transplantation. A crucial factor for the
long-term success of kidney transplantations is the patients' life-long adherence to
immunosuppressant medication. Numerous aspects influencing adherence have been investigated
empirically. Across studies, social support has been shown to have an important impact on
levels of patients' adherence to treatment. In kidney patients, lower levels of social
support have been found to be a risk factor for non-adherence to immunosuppressant therapy,
and impaired integration of the transplantation.
From other long-term and potentially life-threatening medical conditions such as breast
cancer, the patients' husbands/wives, or spouses are often the primary source of (social)
support and of central importance with regard to treatment-related decisions. Thus, spouses
are important agents in the course of treatment but are also under considerable (additional)
strain. Most studies on psychosocial outcomes of organ transplantation have focused on
either patients or spouses. However, medical, social, and psychological aspects influence
transplantation outcomes and patients' as well as spouses functioning in complex interaction
and should be investigated accordingly.
The study at hand aims at investigating the nature of marital / relationship quality and
communication, social support behaviors, emotional arousal, and psychological distress in
patients and their spouses after kidney transplantation. Additionally, the role of these
variables of interest for important post-transplantation outcomes such as the patients'
adherence to immunosuppressive medication and quality of life in both patients and spouses
will be analyzed.
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Observational Model: Case-Only, Time Perspective: Cross-Sectional
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