International Journal of Women's Health (Jun 2018)
Associations between physical and psychosocial factors and health-related quality of life in women who gave birth after a kidney transplant
Abstract
Yuki Yoshikawa,1,2 Junji Uchida,3 Chiharu Akazawa,4 Nobuhiko Suganuma2 1Faculty of Medicine, Osaka City University, Osaka, Japan; 2Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; 3Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan; 4Faculty of Nursing, Osaka Medical College, Osaka, Japan Purpose: Health-related quality of life (HRQOL) among kidney transplant recipients is associated with physical and psychosocial characteristics. Furthermore, pregnancy and childcare may be particularly challenging for women. The aim of this study was to assess the relationship between patients’ psychosocial characteristics and HRQOL, specifically for recipients who have given birth after their kidney transplant.Patients and methods: This was a cross-sectional study. Participants were 59 kidney transplant recipients who had given birth after transplantation. The tools used were the Medical Outcomes Scale, the Kidney Transplantation Self-Management Scale, the Multidimensional Scale of Perceived Social Support (MSPSS), and The Maternal Consciousness Scale.Results: Mean age was 42.3±7.2 years, and the mean age at the time of transplant was 28.2±4.6 years. A total of 82 fetal outcomes were evaluated. Maternal age was 33.6±4.1 years, duration of gestational period was 35.3±3.3 weeks, and birth weight was 2,303.8±592.5 g. HRQOL results were nearly the same as stratified national norms. The physical component summary was positively correlated with the MSPSS (p=0.025), and self-care behavior was positively correlated with the mental component score (p=0.029) and MSPSS (p=0.016). A structural equation model revealed that self-care behavior and the patient–health professions partnership indirectly affected physical health through social support.Conclusion: Self-management indirectly affects physical health through social support. To create a supportive environment through monitoring and consultation with patient families, child-rearing kidney transplant recipients should be encouraged to improve their self-management skills to improve their quality of life. Social support for self-management may contribute to improve HRQOL for women who experience pregnancy and child-rearing after transplantation. Keywords: kidney transplant, quality of life, pregnancy, child-rearing, social support
