A Study On Health-Related Quality Of Life Of Kidney Transplant Receipients Based On The Theory Of Stress And Coping

[Background][Purpose] This study examined the effects of stressors, 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-stress and coping theory.[Methods] Renal transplant recipients with functional kidney graft and more than 3 months after transplantation were recruited at a transplant center clinic. Standardized instruments were used to evaluate the cognitive appraisal of health, perceived self-efficacy, perceived social support, and coping strategies. HRQOL was measured using SF-36 (v2). 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. Path analysis demonstrated that perceived self-efficacy had a significant direct effect on negative cognitive appraisal of health (β=-0.30, P<0.01; β=-0.31, P<0.01)and physical HRQOL(β=0.23, P<0.01), and had both direct and indirect effects through primary appraisal on acceptance-resignation coping strategies(β=-0.16, P=0.01; β=-0.13). Perceived social support had a direct effect on negative primary appraisal (β=-0.12, P=0.04), and direct and indirect effect through threat primary appraisal on surrender coping (β=-0.14, P=0.01, β=-0.05). 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 confrontation coping strategies had no significant direct effects on physical and mental HRQOL.[Conclusion]Health-related quality of life of renal transplant recipients is influenced by a comprehensive interaction among clinical factors, psychosocial factors and coping strategies. More factors should be considered to improve the HRQOL of renal transplant recipients.