The relationship between the sick role and functional status in kidney transplant recipients

The primary purpose of kidney transplantation is physical and social rehabilitation for those with end stage renal disease (ESRD). Although kidney transplantation has demonstrated improved quality of life over dialysis, the dependence on dialysis necessary for survival may create a sick role identity which reinforces dependent existence and relegation of social responsibility. Depending on the physical and psychological effects of illness on functional ability, sick role perceptions formed while on dialysis may be difficult for transplant recipients to relinquish following successful kidney transplantation.;The sick role is a paradigm well entrenched in the literature describing dialysis and transplant patients, however, measurement of sick role perceptions and their effect on post-transplant functional status has not been empirically well studied in the transplant literature.;Using the theoretical framework of Talcott Parsons which addressed the physical and psychological aspects of illness, this descriptive correlational study was an initial attempt to empirically study the sick role in kidney transplant recipients.;The Response to Illness Questionnaire (RIQ) was used to measure sick role perceptions. Factor analysis of the RIQ identified seven distinct factors which accounted for 62.2% of total score variance. The Functional Status Questionnaire (FSQ) was used to measure functional status. The seven factors of the RIQ and the six factors of the FSQ were used to measure the relationship between the sick role and functional status in 97 kidney transplant recipients. Demographic data was obtained from the investigator developed Demographic Data Sheet.;Coping with Illness, Resentment of Illness and Feelings of Guilt were the RIQ factors which demonstrated the strongest influence on functional status in this analysis. This demonstrates that those with the strongest coping abilities seem able to face the challenge of living with ESRD by utilizing the sick role as a transitory step in positive adjustment to ESRD.;The clinical and theoretical relevance of the study to nursing practice is recognized by acknowledging the strong relationships usually developed between those on dialysis and the nurses caring for them. Thus, nurses may be the practitioners most suited to influence positive transition out of the sick role in those who may embrace it.