Depressive symptoms and associated factors among kidney transplant recipients
More details
Hide details
PhD. Professor. Department of Health Services and Health Education, School of health, Iran University of medical science, Tehran, Iran
PhD. Associate Prof. Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
PhD Candidate of Health Education and Health Promotion, Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
PhD. Associate Prof. Department of Community medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Online publication date: 2018-07-14
Publication date: 2018-12-10
Electron J Gen Med 2018;15(6):em93
Depression is one of the most prevalent psychological disorders experienced by kidney transplant (KT) recipients. The aim of this study was to determine the depressive symptoms exhibited by KT recipients and the related factors affecting them.

This descriptive-analytical cross-sectional study was conducted on 131 KT recipients referring to nephrology clinic of Imam Khomeini Hospital, Ardabil, in 2016. Convenience sampling method was employed. Data were collected using personal profile form and Beck Depression Inventory, self-efficacy and self-care behaviors of the KT recipients. Data were analyzed using the descriptive and analytical tests in SPSS software (Version 22).

More than half of the patients exhibited symptoms of depression. The mean depression score was 15.55±19.48, indicating mild depression. Multiple linear regression indicated that depression symptoms were significantly associated with self-efficacy, self-care behaviors, symptom distress, age and marital status.

Self-efficacy and self-care behaviors found to be the efficacious and modifiable factors of depressive symptoms in KT recipients. Therefore, self-efficacy and self-care promotion in these patients should be a significant part of care plans these patients. In addition, depression and its related factors should be part of routine screening measures for KT recipients. Patients with signs of depression should undergo individual interventions based on the specific conditions of each patient.

Lin X, Lin J, Liu H, Teng S, Zhang W. Depressive symptoms and associated factors among renal-transplant recipients in China. Int J Nurs Sci. 2016;3(4):347-53. https://doi.org/10.1016/j.ijns....
Little DJ, Ward M, Nee R, Yuan CM, Oliver DK, Abbott KC, et al. Depression and Immunosuppressive Therapy Adherence Following Renal Transplantation in Military Healthcare System Beneficiaries. Kidney Int Rep. 2017;2(2):248-50. Epub 2017/11/17. https://doi.org/10.1016/j.ekir... PubMed PMID: 29142960; PubMed Central PMCID: PMCPmc5678652.
Zelle DM, Dorland HF, Rosmalen JG, Corpeleijn E, Gans RO, Homan van der Heide JJ, et al. Impact of depression on long-term outcome after renal transplantation: a prospective cohort study. J Transplant. 2012;94(10):1033-40. Epub 2012/10/16. https://doi.org/10.1097/TP.0b0... PubMed PMID: 23064656.
Anvar-Abnavi M, Bazargani Z. Prevalence of anxiety and depression in Iranian kidney transplant recipients. Neurosciences (Riyadh). 2010;15(4):254-7. Epub 2010/10/20. PubMed PMID: 20956922.
Veater NL, East L. Exploring Depression Amongst Kidney Transplant Recipients: A Literature Review. J Ren Care. 2016;42(3):172-84. Epub 2016/05/26. https://doi.org/10.1111/jorc.1... PubMed PMID: 27220908.
Karaminia R, Tavallaii SA, Lorgard-Dezfuli-Nejad M, Moghani Lankarani M, Hadavand Mirzaie H, Einollahi B, et al. Anxiety and depression: a comparison between renal transplant recipients and hemodialysis patients. Transplant Proc. 2007;39(4):1082-4. Epub 2007/05/26. https://doi.org/10.1016/j.tran... PubMed PMID: 17524897.
Weng LC, Dai YT, Wang YW, Huang HL, Chiang YJ. Effects of self-efficacy, self-care behaviours on depressive symptom of Taiwanese kidney transplant recipients. J Clin Nurs. 2008;17(13):1786-94. Epub 2008/02/13. https://doi.org/10.1111/j.1365... PubMed PMID: 18266845.
Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143-64. Epub 2004/04/20. https://doi.org/10.1177/109019... PubMed PMID: 15090118.
Baines LS, Joseph JT, Jindal RM. Compliance and late acute rejection after kidney transplantation: a psycho-medical perspective. Clin Transplant. 2002;16(1):69-73. Epub 2002/05/02. PubMed PMID: 11982618.
Allegrante JP, Marks R. Self-efficacy in management of osteoarthritis. Rheum Dis Clin North Am. 2003;29(4):747-68. https://doi.org/10.1016/S0889-... PubMed Central PMCID: PMC14603581.
Clark NM, Dodge JA. Exploring self-efficacy as a predictor of disease management. Health Educ Behav. 1999;26(1):72-89. Epub 1999/02/10. https://doi.org/10.1177/109019... PubMed PMID: 9952053.
Sousa VD, Zauszniewski JA, Musil CM, Price Lea PJ, Davis SA. Relationships among self-care agency, self-efficacy, self-care, and glycemic control. Res Theory Nurs Pract. 2005;19(3):217-30. Epub 2005/09/08. PubMed PMID: 16144240.
Curtin RB, Mapes D, Schatell D, Burrows-Hudson S. Self-management in patients with end stage renal disease: exploring domains and dimensions. Nephrol Nurs J. 2005;32(4):389-95. Epub 2005/09/27. PubMed PMID: 16180780.
Kobau R, DiIorio C. Epilepsy self-management: a comparison of self-efficacy and outcome expectancy for medication adherence and lifestyle behaviors among people with epilepsy. Epilepsy Behav. 2003;4(3):217-25. Epub 2003/06/07. PubMed PMID: 12791322.
Tsay SL, Chao YF. Effects of perceived self-efficacy and functional status on depression in patients with chronic heart failure. J Nurs Res. 2002;10(4):271-8. Epub 2003/01/11. PubMed PMID: 12522740.
Pasha AA, Alijanpour S, Khafri S, Basim H, Afshang M. Side Effects of Transplant Immunosuppressive Therapy in Post Renal Transplant Recipients, Mazandaran, Northern Iran. Zahedan Journal of Research in Medical Sciences. 2017;19(4). https://doi.org/10.5812/zjrms.....
Rosenberger J, Geckova AM, Dijk JP, Roland R, Heuvel WJ, Groothof FJ. Factors modifying stress from adverse effects of immunosuppressive medication in kidney transplant recipients. Clin Transplant. 2005;19(1):70-6. Epub 2005/01/22. https://doi.org/10.1111/j.1399... PubMed PMID: 15659137.
Overbeck I, Bartels M, Decker O, Harms J, Hauss J, Fangmann J. Changes in quality of life after renal transplantation. Transplant Proc. 2005;37(3):1618-21. Epub 2005/05/04. https://doi.org/10.1016/j.tran... PubMed PMID: 15866689.
Achille MA, Ouellette A, Fournier S, Vachon M, Hebert MJ. Impact of stress, distress and feelings of indebtedness on adherence to immunosuppressants following kidney transplantation. Clin Transplant. 2006;20(3):301-6. Epub 2006/07/11. https://doi.org/10.1111/j.1399... PubMed PMID: 16824145.
Chen KH, Weng LC, Lee S. Stress and stress-related factors of patients after renal transplantation in Taiwan: a cross-sectional study. J Clin Nurs. 2010;19(17-18):2539-47. Epub 2010/06/29. https://doi.org/10.1111/j.1365... PubMed PMID: 20579191.
Jana AK, Sircar D, Waikhom R, Praharaj SK, Pandey R, RayChaudhury A, et al. Depression and anxiety as potential correlates of post-transplantation renal function and quality of life. Indian J Nephrol. 2014;24(5):286-90. Epub 2014/09/25. https://doi.org/10.4103/0971-4... PubMed PMID: 25249717; PubMed Central PMCID: PMCPmc4165052.
Calia R, Lai C, Aceto P, Luciani M, Camardese G, Lai S, et al. Emotional self-efficacy and alexithymia may affect compliance, renal function and quality of life in kidney transplant recipients: results from a preliminary cross-sectional study. Physiol Behav. 2015;142:152-4. Epub 2015/02/15. https://doi.org/10.1016/j.phys... PubMed PMID: 25680476.
Gelb SR, Shapiro RJ, Thornton WJ. Predicting medication adherence and employment status following kidney transplant: The relative utility of traditional and everyday cognitive approaches. J Neuropsychol. 2010;24(4):514-26. Epub 2010/07/08. https://doi.org/10.1037/a00186... PubMed PMID: 20604625.
Ronai KZ, Szentkiralyi A, Lazar AS, Ujszaszi A, Turanyi C, Gombos F, et al. Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients. J Clin Sleep Med. 2017;13(4):557-64. Epub 2017/02/07. https://doi.org/10.5664/jcsm.6... PubMed PMID: 28162142; PubMed Central PMCID: PMCPmc5359332.
Weng LC, Dai YT, Huang HL, Chiang YJ. Self-efficacy, self-care behaviours and quality of life of kidney transplant recipients. J Adv Nurs. 2010;66(4):828-38. Epub 2010/04/29. https://doi.org/10.1111/j.1365... PubMed PMID: 20423370.
Parsaei Mehr Z, Hami M, Moshtagh Eshgh Z. Anxiety and Depression: A Comparison between Living and Cadaveric Renal Transplant Recipients. Int J Organ Transplant Med. 2011;2(4):178-83. Epub 2011/01/01. PubMed PMID: 25013612; PubMed Central PMCID: PMCPmc4089269.
Schäfer-Keller P. Patient self-management in kidney transplantation. definition, measurement, and intervention. [dissertation] [Switzerland]. University_of_Basel; 2009. https://doi.org/10.5451/unibas... http://edoc.unibas.ch/diss/Dis....
Chou KL, Yeung FK, Wong EC. Fear of falling and depressive symptoms in Chinese elderly living in nursing homes: fall efficacy and activity level as mediator or moderator? Aging Ment Health. 2005;9(3):255-61. Epub 2005/07/16. https://doi.org/10.1080/136078... PubMed PMID: 16019279.
Sacco WP, Wells KJ, Vaughan CA, Friedman A, Perez S, Matthew R. Depression in adults with type 2 diabetes: the role of adherence, body mass index, and self-efficacy. Health Psychol. 2005;24(6):630-4. Epub 2005/11/17. https://doi.org/10.1037/0278-6... PubMed PMID: 16287410.
Mancuso CA, Rincon M, McCulloch CE, Charlson ME. Self-efficacy, depressive symptoms, and patients’ expectations predict outcomes in asthma. Med care. 2001;39(12):1326-38. Epub 2001/11/22. PubMed PMID: 11717574.
Gonyea JG, O’Connor M, Carruth A, Boyle PA. Subjective appraisal of Alzheimer’s disease caregiving: the role of self-efficacy and depressive symptoms in the experience of burden. Am J Alzheimers Dis Other Demen. 2005;20(5):273-80. Epub 2005/11/09. https://doi.org/10.1177/153331... PubMed PMID: 16273992.
Rayyani M, Malekyan L, Forouzi MA, Razban AHF. Self-care self-efficacy and quality of life among patients receiving hemodialysis in South-East of Iran. AJNER. 2014;4(2):165. Retrieved from http://ajner.com/AbstractView.....
Akman B, Ozdemir FN, Sezer S, Micozkadioglu H, Haberal M. Depression levels before and after renal transplantation. Transplant Proc. 2004;36(1):111-3. Epub 2004/03/12. https://doi.org/10.1016/j.tran... PubMed PMID: 15013316.
Szeifert L, Molnar MZ, Ambrus C, Koczy AB, Kovacs AZ, Vamos EP, et al. Symptoms of depression in kidney transplant recipients: a cross-sectional study. Am J Kidney Dis. 2010;55(1):132-40. Epub 2009/11/26. https://doi.org/10.1053/j.ajkd... PubMed PMID: 19932540.
Journals System - logo
Scroll to top