Adherence in adolescents with chronic kidney disease and after kidney transplantation

Česká verzia

Authors: Z. Kocábová ^1,2; T. Urbánek ³
Authors place of work: Oddělení klinické psychologie, Fakultní nemocnice Motol, Praha ¹; Fakulta sociálních studií, Masaryková univerzita Brno ²; Psychologický ústav Akademie věd, v. v. i., Brno ³
Published in the journal: Čes-slov Pediat 2020; 75 (8): 465-473.
Category: Original Papers

Summary

Adherence is a crucial factor which influences treatment outcomes for organ transplantation. There are a number of aspects which impact adherence. The primary one is a personal belief system which generally influences the patient‘s behavior. Our qualitative study evaluated personal beliefs about adherence/nonadherence motivation in the patients in the transplantation program.

Method: Fourteen adolescent patients were interviewed before or after the kidney transplantation and one patient after the liver transplantation. Their age was 13–18 years and patients with serious psychiatric diagnoses were excluded. We created two groups – patients with adherence behavior and patients with nonadherence behavior in their history. We interviewed them to identify their beliefs about motives for taking or not taking pills. The interview was based on the theory of cognitive orientation.

Results: We found 15 motives for adherent behavior and 16 motives for nonadherent behavior. According to nonadherent patients the most important motives for nonadherence were depression, lost of life meaning, and tendency to self-harm behavior. In contrast, the adherent patients mentioned the lack of interest in health condition conecting with irresponsibility and "lazyness". In both patients group the crucial factor for adherence was connected with improving and/or keeping the quality of life.

Conclusion: We found differencies in the beliefs about motives for adherence and nonadherence between both groups of patients. All patients considered the transplanation is the way how to improve quality of their lives.

Keywords:

adherence – Transplantation – Adolescents – motives – beliefs

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