Aim: To assess psychological symptoms, quality of life and adherence to immunosuppressive therapy in kidney transplant recipients. Design: Cross-sectional study was conducted in kidney transplant recipients. Methods: This cross-sectional study included a total of 96 consecutive patients at least 3 months after kidney transplantation from September 2019 to November 2019. Psychological symptoms (anxiety, stress and depression) were assessed using the Depression, Anxiety and Stress Scale. The World Health Organization Quality of Life Instrument was used to assess quality of life in kidney transplant recipients. Adherence to immunosuppressive therapy was assessed by the Morisky Green Levine (MGL) adherence scale. The demographic and clinical details were assessed with a validated self-structured questionnaire. Results: The study included a young adult male population with a mean age of 38.82±10.53 years. The majority of patients reported at least some psychological abnormalities, with mild stress being the most common and presenting in 73% of patients. Importantly, 29% and 21% of patients reported anxiety and depression. Stress was significantly associated with gender, post-transplantation infection and hospitalisation. Anxiety was significantly associated with low family income and post-transplant complication of infection. Psychological symptoms significantly affected the various domains of quality of life of the patients. None of the surveyed patients had low adherence, while 56 (58.3%) had medium adherence to immunosuppressive therapy. Patients with medium adherence to immunosuppressive therapy had significantly lower scores in physical (p=0.01) and social relationship (p= 0.004) domains of quality of life. Conclusion: A significant number of young and stable kidney transplant recipients have presented with psychological symptoms (mainly depression) that affected their quality of life. The presence of psychological symptoms can not only hamper quality of life, but also affect their compliance to drugs. Impact: Psychological health is an important concern after kidney transplantation. Nurses should include assessment of psychological symptoms in their care that would further help in improving quality of life and adherence to drugs in kidney transplant recipients.
Development and validation of the Kidney Transplantation and Quality of Life, a Korean questionnaire to assess the general quality of life and other health issues associated with medication change in kidney transplant recipients