EMOTIONAL ADJUSTMENT AND COMPLIANCE

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The purpose of this project is to identify psychosocial predictors of treatment compliance among kidney transplant recipients. Given the frequency of noncompliance and the severity of its consequences (e.g., rejection, graft loss), identification of factors related to noncompliance is a necessary step toward improving survival rates among transplant recipients. Virtually no research on the psychosocial predictors of noncompliance among transplant recipients currently exists, although research in other health domains provides clues to such predictors. These include perceptions of control over one's health, social support, and coping strategies. These particular factors are important because they are modifiable and thus potential targets for intervention efforts. In addition, these factors have been found to be associated with emotional adjustment as well as compliance which is important because individuals with emotional adjustment problems tend to be less compliant. The primary goal of this project is to examine the reactions between treatment compliance and three key psychosocial variables: control beliefs, social support, and coping strategies. The relations between these variables and adjustment also will be explored as well because of the central role they play in influencing both compliance and adjustment. Specifically, data on compliance, emotional adjustment, and psychosocial predictors of compliance and adjustment (i.e., control beliefs, social support, coping strategies) will be gathered from kidney transplant recipients and their caregivers at the University of Minnesota Hospital using a prospective panel design. Longitudinal data, gathered at 3 and 12 months post-transplant, will allow for an assessment of the direction of the relations among variables as well as changes in adjustment and compliance over time. The results of this study will enable health care providers to identify transplant recipients who may be at higher risk for noncompliance. The identification of predictors of noncompliance that are modifiable also can lead to more effective interventions to improve compliance.