Symptom occurrence, symptom distress, and quality of life in renal transplant recipients

Renal transplantation has become an increasingly common option for End Stage Renal Disease in the past 20 years. Successful transplant recipients are required to change their views of the world, and to adapt physically, socially, and psychologically to their new lives. This is a descriptive correlation study about symptom occurrence, symptom distress, and quality of life (QOL) in a convenience sample of 100 renal transplant recipients (76 cadaver, 24 living donor) in the southern United States. Subjects were 68 males and 32 females, 67 White and 33 Black, with an age range from 21 to 69 years. Time since transplant varied from 11 months to 24.8 years (average of 6.5 years) with a mean serum creatinine of 1.5 mg/dl. All subjects were receiving prednisone as one drug in a two drug (16%) or three drug (84%) immunosuppression regimen. Subjects with insulin dependent diabetes accounted for 20% of the sample.; The study was approved by the LSUHSC Institutional Review Board and subjects signed a consent form prior to participation. The Transplant Symptom and Occurrence and Distress Scale (Lough, Lindsey, Shinn, & Stotts, 1987) and The Center for Health Promotion Quality of Life Tool (Renwick, Brown, and Nagler, 1996) were used for data collection. Symptom occurrence was reported by all respondents with the following most frequently reported symptoms (>65%): sleep problems, overeating, fatigue, changed body and facial appearance, mood swings, swollen ankles, decreased interest in sex, and headache. The highest frequency of individual symptom occurrence was reported in the rarely to sometimes range. Analysis of variance (ANOVA) revealed a significant difference for females (F(1,99) = 6.6064, p = 0.02) on the symptoms of fatigue, changed facial and changed body appearance, skin fragility, fever, and pain which occurred more frequently than for male subjects. No statistical differences were found in symptom occurrence for the variables of race or age.; Symptom distress was reported by all subjects for the same symptoms as those reported for symptom occurrence. The most common individual symptom distress reports were in the range of rarely to sometimes. ANOVA revealed more symptom distress in female subjects (F(1.98) = 5.09, p = .02) than in males for breathing problems, changed body and facial appearance, skin fragility, excessive hair, and fever. ANOVA showed differences in age with younger subjects (age 21 to 35) reporting less sleep problems and pain than the middle age group (age 36 to 50), and less pain, fatigue, and skin fragility but more acne than the older age group (age 51 to 69 years). There was no statistical difference in symptom distress for race. (Abstract shortened by UMI.)...