Comparison of medical coping styles in renal transplant patients and hemodialysis patients☆

Hongbo GUO; Fengqi FU

ABSTRACT

BACKGROUND:

The perception evaluation of treatment can influence the patients' coping activities and psychosomatic reactions. Therefore, the medical coping mode adopted by patients is one of the most important medium factors affecting clinical treatment.

OBJECTIVE:

To explore the characteristics and influencing factors of medical coping styles in hemodialysis patients and renal transplant patients.DESIGN, TIME AND

SETTING:

Questionnaire investigation was performed from January 2005 to January 2006 in Department of Urology, Beijing Friendship Hospital, Capital Medical University (Beijing, China).

PARTICIPANTS:

Sixty hemodialysis outpatients and 60 renal transplant outpatients with normal graft function from Beijing Friendship Hospital of Capital Medical University, were enrolled into this study. All the patients had to fulfill the questionnaire investigation.

METHODS:

Questionnaire investigation was carried out in 60 hemodialysis patients and 60 renal transplant patients.Patients completed the questionnaires following instructions by investigators.The interview scale included variables such as gender, age education, occupation, marital status, children, family income, payment mode, influence of medical cost on family, time receiving hemodialysis and time after renal transplantation, etc. Medical coping mode questionnaire contains three subscales Confrontation. Avoidance and Acceptance-Resignation. Patients scored the questions over a range of 1 to 4 points. A higher score indicated a higher coping tendency adopted by patients.MAIN OUTCOME

MEASURES:

All the patients were scored by each scale of Confrontation, Avoidance and Acceptance-Resignation, and were compared with the norms. Pearson's correlation analysis was used to explore the correlation between coping modes and influencing factors in hemodialysis patients and renal transplant patients.

RESULTS:

All 120 patients were involved in the result analysis. There were significant differences between hemodialysis patients and renal transplant patients in medical payment modes, the influence of medical cost on family, and the time on hemodialysis/time after renal transplantation (P<0.05).The average scores of Confrontation and Acceptance-Resignation in hemodialysis patients were lower than those in renal transplant patients (P<0.05). The Avoidance scores showed no significant differences in two groups of the patients (P>0.05). The average score of Confrontation in hemodialysis patients was lower than the norm (P<0.05), and the average scores of Avoidance and Acceptance-Resignation in hemodialysis patients were higher than the norms (P<0.05). The renal transplant patients exhibited similar scores of Confrontation as the norm, without significant differences (P>0.05). The average scores of Avoidance and Acceptance-Resignation in renal transplant patients were higher than the norms (P<0.05). In hemodialysis patients, the score of Confrontation was correlated with the gender of patients (r=-0.277, P<0.05); the score of Acceptance-Resignation was correlated with the family income (r=-0.287, P<0.05). In renal transplant patients, the score of Confrontation was correlated with the marital status (r=0.282, P<0.05).

CONCLUSION:

The medical coping style adopted by end-stage renal disease patients is influenced by the clinical treatment methods and psychosocial factors.Compared to the hemodialysis patients, renal transplant patients are prone to the Confrontation and Acceptance-Resignation. As for the hemodialysis patients, the score of Confrontation is correlated with the gender of patients, the score of Acceptance-Resignation is correlated with the family income.In renal transplant patients,the score of Confrontation is correlated with the marital status.