title: Q-methodology to identify young adult renal transplant recipients at risk for nonadherence.
abstract: BACKGROUND
  Young adult renal transplant recipients may display patterns of behavior that affect graft survival. The present study aimed to identify young adults at risk for nonadherent behavior by investigating their attitudes about posttransplant health lifestyle.
  
  
  METHODS
  A Q-methodological study was conducted. Participants were asked to rank-order statements on issues potentially associated with (non)adherence. Factor analysis was applied to uncover patterns in the ranking of statements. The resulting factors represent attitudes and are described using a composite ranking of the statements. As a first test of discriminated validity, a different group of 34 young renal transplant patients was asked how well the factor descriptions fitted them.
  
  
  RESULTS
  Twenty-six young renal transplant recipients (18-25 years) participated in the study. They were remarkably willing to discuss sensitive issues when confronted with statements on cards. Four distinct attitude profiles concerning posttransplant health lifestyle were found among these young adults: (a) concerned and controlled, (b) appearance orientated, (c) opinionated and independent, and (d) easy going and pliable. In a follow-up analysis, self-categorization proved to discriminate well between the four attitude profiles in 67% of the respondents.
  
  
  CONCLUSIONS
  Using Q-methodology, four attitude profiles about posttransplant health lifestyle were uncovered. Self-categorization on these attitudes seems feasible and may be a useful screening aid to identify young adults at risk for nonadherence.
authors.affiliation: Department of Internal Medicine, University Medical Center, Erasmus MC, Rotterdam, The Netherlands. m.tielen@erasmusmc.nl
authors.forename: Mirjam
authors.initials: M
authors.lastname: Tielen
authors.forename: Anne Loes
authors.initials: AL
authors.lastname: van Staa
authors.forename: Susan
authors.initials: S
authors.lastname: Jedeloo
authors.forename: N Job A
authors.initials: NJ
authors.lastname: van Exel
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006798:Housing; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology* / Q000523:psychology*; D008019:Life Style; D008297:Male; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D016312:Treatment Refusal