The quality of life after kidney transplantation : an analysis / Joylyn L. Mejilla 6

Thesis (M.A.) -- Pamantasan ng Lungsod ng Maynila, Intramuros, Manila, 2000.;A thesis presented to the faculty of Graduate School of Arts, Sciences, Education, and Nursing, Pamantasan ng Lungsod ng Maynila in partial fulfillment of the requirements for the degree of Master of Arts in Nursing. 56

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ABSTRACT. Statement of the Problem: This study aimed at determining the quality of life after kidney transplantation. The following specific questions were answered: 1. What is the socio-demographic profile of the kidney transplant patients in terms of age, sex, civil status, religion, educational attainment, occupation (past and present work) and income? 2. What is the past-medical history of kidney transplant patients in terms of cause of renal disease, type of dialysis, length of time on maintenance dialysis, patient classification, source of donor, date of transplantation and length of hospital stay after operation? 3. What is the over-all quality of life of kidney transplant patients in terms of physical wellness, emotional well-being, social functioning, functional capacity, cognitive functioning and spiritual well-being? 4. Is there a significant relationship between the socio-demographic profile and past medical history of kidney transplant patient and quality of life? 5. Which of the aforementioned variables predict the quality of life of kidney transplant patient? Research Methodology: The study utilized the descriptive-correlational design. The sample of the study was consisted of 200 kidney transplant patients from National Kidney and Transplant Institute (NKTI) and members of Kidney Transplant Association and the Philippines (KITAP). Purposive sampling technique was employed. The Quality of Life Scale for Kidney Transplant Patient was the main instrument used in the study. The tool contains 36 questions in 6 dimensions of quality (physical, emotional, social, functional, cognitive, and spiritual). This is a self-administered tool and took 10-15 minutes to complete the questionnaire. Respondents were asked to consider how kidney transplantation had affected his well being for the past two weeks. Statistical Method: Frequency distribution was used to describe the characteristics of kidney transplant patients in terms of socio-demographic profile and past-medical history. Mean was utilized to assess the over-all and dimension-specific quality of life of kidney transplant patients. Pearson's r was used to determine the magnitude of relationship between the variables and quality of life. Lastly, stepwise multiple regression was used to determine which set of variables is significant to quality of life of kidney transplant patients. Summary of Findings: The following are the findings of the study: 1. Majority of the respondents are middle adult, between 36-65 years old (52.55%); male (58.16%); married (60.50%); Catholic (79%); college graduates (53.50%) not employed (46%) and not receiving income (48.19%) 2. Glomerulonephrities is clearly the most common cause of renal disease (59.89%) and hemodialysis (64.32%) is the most common used treatment modality of ESRD before kidney transplantation. The mean length of time on maintenance dialysis for both hemodialysis and peritoneal dialysis is 9 and 7 months, respectively. Majority is service patients (77%), received kidney from living-related donor (88.50%). And the mean date of transplantation is 4 years while the mean length of stay in the hospital after kidney transplant operation is 15 days. 3. The over-all quality of life of kidney transplant patient is very high with a mean score of 5.67. Among the six dimensions of quality of life, the spiritual well being ranks first with a mean of 6.65 which is a perfect quality of life. Social functioning (x=5.87), cognitive functioning (x=5.58) and emotional well-being (x=5.54) got a very high quality of life. While physical wellness (x=5.49) and functional capacity (x=5.00) got a high quality of life. 4. Age, sex, educational attainment and patient classification are significantly related to quality of life. 5. The predictors of the quality of life after kidney transplantation are age, education, patient classification and civil status. The older patients, the more educated patients, pay/private patients and single patients have better quality of life. Conclusions: 1. Renal disease commonly affects the male. Employment is greatly affected following kidney transplant operation. 2. Glomerulonephritis is the common cause of ESRD. Hemodialysis is the common treatment modality before kidney transplant operation. Living-related donor is the major source of kidney used for kidney transplant operation. 3. Over-all quality of life of kidney transplant patients is very high following transplantation. Among the six dimensions of quality of life, spiritual well being has the highest mean score while functional capacity got the lowest mean score. 4. Age, education, patient classification and civil status are the predictors of quality of life after kidney transplant operation. While, sex is significantly related to quality of life. 5. Kidney transplantation is the treatment of choice for ESRD patients. There can be no doubt that successfully transplant patients enjoy a better quality of life. Recommendations: 1. Support groups or government-initiated agency must be established to assist patients deal with the financial difficulties brought about by kidney transplantation. 2. Chronic glomerulonephritis is a potentially preventable disease, thus, early detection and prevention must be given emphasis to avert the increasing number of cases of end-stage renal disease. 3. At present, the number of living-related donor is not adequate to meet the increasing demand of kidney transplantation. Public campaigns on organ donation must be intensified in all sectors of society. 4. Spiritual health must be further advocated in nursing education so that our graduates can effectively reinforce this aspect of quality of life. 5. Emphasis on functional capacity and physical wellness of kidney transplant patients must be of utmost nursing concern when planning and implementing nursing care. 6. For future research, consider other factors that are not included in this study would likely predict the quality of life of kidney transplant patients.

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