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Life and work: the health-related quality of life and employment outcomes of rental transplant recipients Ferguson, Beryl M.

Abstract

This study was designed to investigate patient outcomes following kidney transplantation in terms of health-related quality of life and employment status. In addition it was designed to identify, in terms of relative contribution, the main factors or characteristics that are associated with employment from the perspective of the renal transplant recipient. The study was conducted in two stages. In stage one, 216 adult renal transplant recipients from the lower mainland of British Columbia completed a mail questionnaire on their health-related quality of life and their employment circumstances. In stage two, using a maximum variation sampling strategy, seven adult transplant recipients participated in a personal interview. The results from this work indicate that a person's health-related quality of life following renal transplantation is less than optimal. Limitations persist particularly in the area of physical functioning and the ability to perform usual roles at home, school and work. The area least affected is the transplant recipients’ mental health. People with renal transplants generally adjust well to their condition and their mental health approaches the levels found in the general population. Employment prospects are diminished for people with kidney transplants. Employment rates lag behind the rates in the general population. The reasons for this finding are complex and reside in the individual as well as the socio-cultural, economic and political reality. When poor functional health is compounded by limited education, increased age, interruptions in work and the unavailability of suitable work, disadvantages in employment increase. The health and employment outcomes of renal transplant recipients provide estimates of the need for social work services and allow monitoring of progress toward meeting the goal of full rehabilitation in this population. Identifying and mapping the factors that contribute to employment using the PRECEDE-PROCEED model for health promotion planning and evalution is a useful guide to selecting and directing intervention where it is most needed. The findings of this study raise questions about quantifying a realistic employment goal for renal transplant recipients. It is recommended that further research be conducted to determine the barriers to employment found among other groups of chronically ill persons in order to develop a broad strategy for improving access and equal opportunity to jobs for all who desire them.

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