Association between negative emotional states, self-regulation skills, and immunosuppressive medication adherence in liver or kidney transplant recipients: a cross-sectional study

肝肾移植受者负面情绪状态、自我调节能力与免疫抑制药物依从性之间的关联:一项横断面研究

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Abstract

AIM: This study aimed to assess the relationship between negative emotions, self-regulation skills, and immunosuppressive medication adherence in liver or kidney transplant recipients, as well as to identify predictors of negative emotional states. BACKGROUND: Solid organ transplantation is a crucial and life-saving procedure; however, it presents significant physical, psychological, and social challenges for recipients. Negative emotional states (NESs) including depression, anxiety, and stress are frequently observed among liver or kidney transplant recipients. These emotional difficulties can impact their self-regulation abilities and adherence to immunosuppressive medications, ultimately affecting post-transplant outcomes. METHODS: A cross-sectional study of 221 liver or kidney transplant recipients (3 to 18 months post-transplant) was conducted at a tertiary hospital in Tehran, Iran. Data were collected through phone interviews using the DASS-21, SSIt, and BAASIS scales. The study followed the STROBE checklist for reporting and utilized descriptive statistics, correlation analyses, and linear regression for data analysis. RESULTS: A moderately strong negative correlation was found between self-regulation skills and NESs (r = -0.68). Poor adherence to immunosuppressive medication was at 23.1%, mainly due to timing non-adherence and missed doses. Regression analysis indicated that younger age, comorbidities, less success and more setbacks in self-regulation skills predicted higher NESs (R² = 0.528). Medication adherence had no significant association with NESs and self-regulation. CONCLUSION: Negative emotional states are moderately prevalent among transplant recipients and are frequently associated with difficulties in self-regulation, younger age, and various health conditions. Interventions that offer psychological support, provide training in self-regulation, and address socioeconomic barriers have the potential to enhance emotional well-being and improve post-transplant outcomes.

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