Posttraumatic growth and treatment adherence among adolescent renal transplant recipients
Ratcliff, Megan Benoit
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OBJECTIVE: To assess the affect of hardiness, coping, and appraisal on medication non-adherence and posttraumatic growth (PTG) among adolescent renal transplant recipients using Folkman & Greer’s Model of Appraisal and Coping Processes. METHODS: Thirty-three adolescents completed orally-administered questionnaire packets containing measures of the above stated constructs. Twelve-month serum immunosuppressant levels were obtained from medical records to assess non-adherence. RESULTS: Sixty-one percent of adolescent renal transplant recipients report taking immunosuppressant medications late. They also report moderate levels of PTG. The inverse relationship between PTG and immunosuppressant doses taken late trended towards significance. Hardiness, coping, and appraisal were all significantly related to PTG; coping and appraisal were also related to self-reported immunosuppressant doses taken late. Hardiness was negatively correlated with serum immunosuppressant SD (an indicator of possible non-adherence). Coping was found to mediate the relationship between appraisal and PTG but not the relationship between appraisal and immunosuppressant doses taken late or the relationship between hardiness and immunosuppressant SD or PTG. A trend toward negative religious appraisal mediating the relationship between maladaptive coping and immunosuppressant doses late was also found. Lastly, gender was not found to moderate the relationship between hardiness and PTG. CONCLUSIONS: This is one of the first studies to assess PTG and medication non-adherence among adolescent renal transplant recipients. Participants in this study reported moderate levels of PTG and, consistent with the literature, relatively high levels of medication non-adherence. Hardiness, coping, and appraisal were found to have direct and indirect affects on PTG and non-adherence measures, suggesting multiple targets for intervention.