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Do pre-transplant cultural factors predict health-related quality of life after kidney transplantation?
Loor, Jamie M; Ford, C Graham; Leyva, Yuridia; Swift, Samuel; Ng, Yue Harn; Zhu, Yiliang; Dew, Mary Amanda; Peipert, J Devin; Unruh, Mark L; Croswell, Emilee; Kendall, Kellee; Puttarajappa, Chethan; Shapiro, Ron; Myaskovsky, Larissa.
Afiliación
  • Loor JM; Center for Healthcare Equity in Kidney Disease (CHEK-D), University of New Mexico Health Sciences, Albuquerque, New Mexico, USA.
  • Ford CG; Durham VA Medical Center, Durham, North Carolina, USA.
  • Leyva Y; Center for Healthcare Equity in Kidney Disease (CHEK-D), University of New Mexico Health Sciences, Albuquerque, New Mexico, USA.
  • Swift S; College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA.
  • Ng YH; Department of Internal Medicine, University of Washington, Seattle, Washington, USA.
  • Zhu Y; Department of Internal Medicine, University of New Mexico, School of Medicine, Albuquerque, New Mexico, USA.
  • Dew MA; Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Peipert JD; Department of Medical Social Sciences and Transplant Outcomes Research Collaboration, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Unruh ML; Department of Internal Medicine, University of New Mexico, School of Medicine, Albuquerque, New Mexico, USA.
  • Croswell E; Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Kendall K; Highmark Health, Pittsburgh, Pennsylvania, USA.
  • Puttarajappa C; Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Shapiro R; Mount Sinai Recanati/Miller Transplantation Institute, Icahn School of Medicine, New York, USA.
  • Myaskovsky L; Center for Healthcare Equity in Kidney Disease (CHEK-D), University of New Mexico Health Sciences, Albuquerque, New Mexico, USA.
Clin Transplant ; 38(2): e15256, 2024 02.
Article en En | MEDLINE | ID: mdl-38400674
ABSTRACT

BACKGROUND:

Post-transplant health-related quality of life (HRQOL) is associated with health outcomes for kidney transplant (KT) recipients. However, pretransplant predictors of improvements in post-transplant HRQOL remain incompletely understood. Namely, important pretransplant cultural factors, such as experience of discrimination, perceived racism in healthcare, or mistrust of the healthcare system, have not been examined as potential HRQOL predictors. Also, few have examined predictors of decline in HRQOL post-transplant.

METHODS:

Using data from a prospective cohort study, we examined HRQOL change pre- to post-transplant, and novel cultural predictors of the change. We measured physical, mental, and kidney-specific HRQOL as outcomes, and used cultural factors as predictors, controlling for demographic, clinical, psychosocial, and transplant knowledge covariates.

RESULTS:

Among 166 KT recipients (57% male; mean age 50.6 years; 61.4% > high school graduates; 80% non-Hispanic White), we found mental and physical, but not kidney-specific, HRQOL significantly improved post-transplant. No culturally related factors outside of medical mistrust significantly predicted change in any HRQOL outcome. Instead, demographic, knowledge, and clinical factors significantly predicted decline in each HRQOL domain physical HRQOL-older age, more post-KT complications, higher pre-KT physical HRQOL; mental HRQOL-having less information pre-KT, greater pre-KT mental HRQOL; and, kidney-specific HRQOL-poorer kidney functioning post-KT, lower expectations for physical condition to improve, and higher pre-KT kidney-specific HRQOL.

CONCLUSIONS:

Instead of cultural factors, predictors of HRQOL decline included demographic, knowledge, and clinical factors. These findings are useful for identifying patient groups that may be at greater risk of poorer post-transplant outcomes, in order to target individualized support to patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Riñón Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Clin Transplant Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Riñón Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Clin Transplant Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca