الفهرس 
Anatomical and physiological overviewOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Kidney transplantation has become the treatment of choice for
most patients with (ESRD). Marked improvements in early graft survival
and long-term graft function have made kidney transplantation a more
cost-effective alternative method to dialysis (Linda and Donna, 2013).
Adherence to therapeutic regimen is essential for the survival of
transplanted kidney grafts. In fact, non-adherence is the one of the
leading causes of renal graft loss and has others serious consequences,
including infection, rejection episodes, and consequent resumption of
dialysis (Gordon, Gallant, Sehgal, Conti, and Siminoff, 2013).
Aim of the Study:
The aim of this study was to assess adherence of patients after
kidney transplantation toward therapeutic regimen.
Research Questions:
Is patient after kidney transplantation adhere to his therapeutic
regimen?
Is patient adherence degree affected by the period after
transplantation?
Methodology:
Research design:
A descriptive exploratory design was followed to achieve the aim
of this study.
Research Setting:
This study was conducted at the kidney transplant (out-patient
clinic) of Urology and Nephrology center, Mansoura University.
Subjects:
The study group composed of 3purposive samples of 90 adult
patients who perform kidney transplantation from both sex which divided
into 3 groups. The first group with 3months period post transplantation,
the 2nd group after 6months post transplantation and the 3rd group after
one year post transplantation.
Tools for Data Collection:
Data for this study were collected using the following two tools:
I. Patient structured interview questionnaire: developed by the
researcher, it was based on recent literature to assess demographic
characteristics and patients medical history. II. Questionnaire sheet for Patients’ adherence toward therapeutic
regimen after kidney transplantation: developed by the
researcher based on reviewing the related literature to assess
adherence of patient toward therapeutic regimen after kidney
transplantation.
Results:
The main results of study revealed that:
The mean age for the patients included in the study was 31.6±9.8
for group1, 33.0 ± 11.3 for group2 and 31.3±8.9 for group3,
(83.3%, 70%, 66%) in group1, group2 and group3respectively
were males. (46%, 56%, 73%) in group1, group2 and group3
respectively were married. (43%, 40%, and 46%) in three groups
respectively had secondary school education. (53.3%) in
group1were living in rural areas while (56.7%) in group2 were
living in urban areas and (66%) of studied subjects in group3were
living in urban areas. Regarding adherence to therapeutic regimen after kidney
transplantation, (90%, 80%) in group1and group2 respectively had
partial adherence to therapeutic regimen while 100% in group3 had
partial adherence to therapeutic regimen. (100%) in group1, (90%)
in group2 and group3 adhere to drug regimen. (53.3%) in group1,
(23.3%) in group2 and (10%) in group3 adhere to diet. (70%) in
group1, group3 and (86.7%) in group2 adhere to exercise regimen.
In addition 100% in group1 and (96.7%) in group2 and group3
adhere to follow up regimen. (30%) in group1while (6.7%, 10%) in
group2 and in group3 respectively adhere to infection control
regimen and 100% in the three groups not adhere to cancer
prevention regimen. (35.7%) of the married subjects in group1
while (47.1%) of the married subjects in group2 and (77.3%) of
married subjects adhere to sexual regimen. (87.5%) in group1while
(11.1%) in group2 and (71.4%) in group3 adhere to smoking
cessation regimen.
There was statistically significant difference among the three
groups regarding diet, infection prevention precaution regimen,
sexual and smoking cessation regimen and there was no
statistically significant difference among the three groups regarding
drug, exercise ,follow up ,cancer prevention regimen.
There was statistically significant difference among the three
groups regarding over all adherence to therapeutic regimen after
kidney transplantation.
Regarding the causes of non-adherence of the 3groups to
therapeutic regimen after kidney transplantation, the main cause of
non adherence to medication regimen was (28.89%) forgetfulness.
Also the main cause of non-adherence to exercise regimen was
(18.89%) pain and the main cause of non adherence to smoking
cessation was (10.11%) for social condition.
In addition the main cause of non adherence to diet, follow up,
infection precaution, Cancer screening and sexual regimen was
(56.67%, 81.11%, 71.1%, 98.89%, and 23.33%) lack of knowledge
respectivel relation between socio-demographic characteristic and
overall patient adherence, there was a statistically significant
difference among age, educational level, smoking status of all the
study groups and overall adherences of them while there was no
statistically significant difference among sex and job of all the
study groups and overall adherence of them.
Conclusion
Based on the findings of the present study, it can be concluded
that:
The majority in group1and group2 had partial adherence to
therapeutic regimen while all in group3 had partial adherence to
therapeutic regimen.
Also it can be concluded from this study that adherence with
therapeutic regimen in patients after kidney transplantation differed
significantly by the period after transplantation as well as Level of
adherence decreased with long period after transplantation.
Recommendations
Based on the previous results, the following recommendations are
suggested:
Adherence assessment sheet should be added to the hospital file in
order to identify patient’s adherence before and after
transplantation to help in putting a plan that improve the adherence.
Encouragement periodical assessment for patient’s adherence post
kidney transplantation to identify the causes of none- adherence to
overcome it.
Further researches are recommended to provide patients
undergoing kidney transplantation by the guidelines about the
therapeutic regimen