The perceived threat of the risk for graft rejection and health-related quality of life among organ transplant recipients.
OBJECTIVE
This study was primarily aimed for developing and testing a valid and reliable instrument that measures perceived threat of the risk for graft rejection after organ transplantation. A second aim was to report descriptive data regarding graft rejection and Health-Related Quality of Life.


BACKGROUND
The most serious risk connected with transplantations besides infection is graft rejection.


METHODS
Non experimental, descriptive involving instrument development and psychometric assessment.


METHODS
Questionnaires about perceived threat of the risk for graft rejection and Health-Related Quality of Life were mailed to 229 OTRs between 19-65 years old. The items were formed from a previous interview study. Patients were transplanted with a kidney, a liver or a heart and/or a lung. All patients with follow-up time of one year ± three months and three years ± three months were included.


RESULTS
With an 81% response rate, the study comprised of 185 OTRs, who had received either a kidney (n = 117), a liver (n = 39) or heart or lung (n = 29). Three homogenous factors of perceived threat for graft rejection were revealed, labelled 'intrusive anxiety', 'graft-related threat' and 'lack of control'. Tests of internal consistency showed good item-scale convergent and discriminatory validity. A majority of the OTRs scored low levels for 'intrusive anxiety'. The kidney transplant recipients experienced more 'graft-related threat' by acute graft rejection than those transplanted with a liver, heart or lung.


CONCLUSIONS
In conclusion, this study suggests that it is possible to measure the perceived threat of the risk for graft rejection in three homogenous factors. Relevance to clinical practice.  The instrument perceived threat of the risk for graft rejection, might be usable to measure the impact of fear of graft rejection, to predict needs of pedagogical intervention strategies to reduce fear and to improve Health-Related Quality of Life related to graft rejection.
The Sahlgrenska Academy at University of Gothenburg, Institute of Health and Care Sciences and Sahlgrenska University Hospital, Gothenburg, Sweden. madeleine.nilsson@vgregion.se
Madeleine
M
Nilsson
Anna
A
Forsberg
Lars
L
Bäckman
Annette
A
Lennerling
Lars-Olof
LO
Persson
D000328:Adult; D000368:Aged; D006084:Graft Rejection; D006801:Humans; D008875:Middle Aged; D016377:Organ Transplantation; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden