Working to establish 'normality' post-transplant: a qualitative study of kidney transplant patients.
OBJECTIVE
To explore patients' perceptions and experiences of 'normality' and the influences on this at three time points post-transplant.


METHODS
In-depth interviews with 25 patients at three months, one year and more than three years following kidney transplant. Patients' accounts were compared with Sanderson et al.'s typology of types of normality.


RESULTS
Post-transplant, patients worked hard to re-establish normality, albeit in a 'reset' form. This normality was a very personal construct, shaped by a wide range of factors including age, gender and personal circumstances. Some patients encountered significant challenges in regaining normality, both at three months for those experiencing acute and distressing side effects, and later relating to the long-term side effects of transplant medication and co-morbidities. However, the most dramatic threat to normality (disrupted normality) came from episodes of rejection and transplant failure.


CONCLUSIONS
The main types of normality achieved vary for different conditions. Moreover, despite improvements in health post-transplant and opportunities to build a new, reset normality, the participants recognised the need to pay careful attention to the spectre of future ill health and transplant failure. Transplant failure was therefore a source of disruption that was central to their illness narratives and perceived as an ever present risk.
Faculty of Health, Social Care and Education, St. George's, University of London & Kingston University, London a.boaz@sgul.kingston.ac.uk.
Annette
A
Boaz
Department of Primary Care & Public Health Sciences, Division of Health and Social Care Research, School of Medicine, King's College London, London.
Myfanwy
M
Morgan
D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006084:Graft Rejection / Q000523:psychology; D006262:Health; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011184:Postoperative Period; D036301:Qualitative Research; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires
Kidney transplantation; adherence to medication; normality; patient experience; qualitative; shifting perspectives