Social participation after kidney transplantation

Summary:

Kidney transplantation is nowadays regarded as treatment of choice for chronic renal failure and is compared with dialysis associated with a better quality of life. A ‘new’ kidney evokes the image of restored health, and creates expectations of re-entering ‘normal’ life. However, little is known if kidney transplant recipients are able to participate in society.

Aim of the research project is to examine to what extent transplant recipients participate in society and which factors are associated with participation. Social participation is defined as participation in obligatory activities en leisure activities. ‘Obligatory’ activities are activities connected to expected social roles, such as employment, education and household tasks.

The study assessed 239 transplant recipients, transplanted in the UMCG between 1996 and 2001, by interview. Furthermore, 61 recipients were interviewed twice during the first year after transplantation.

The results show that kidney transplant recipients spend less time on obligatory participation compared with an age and gender matched control group from the general population. They more often have part-time jobs, participate less in sports and have a lower educational level. Although half of the patients are employed, also a half of those employed receive additional social security benefits. Overall, transplantation enables an increase in social participation. However, the level of participation does not equal the level of transplantation before the onset of renal disease. Social participation is mainly influenced by transplantation-related factors (type of donation, side-effects of immunosuppressive medication) and health status (comorbidity: cardiovascular disease), and less by psychological characteristics (perceived control). Participation in leisure activities is associated with personal attributes (extraversion) and physical functioning.