title: Evolution of quality of life in renal transplant recipients and patients with multiple sclerosis: a follow-up study.
abstract: OBJECTIVE
  We aimed to compare the evolution of quality of life in 2 medical conditions under immunotherapy (cadaveric renal transplantation [G1] and multiple sclerosis [G2]), and to assess the clinical significance of the results compared with a representative age-adjusted sample of the general Spanish population (G3).
  
  
  METHODS
  Using a mixed design (2 × 2), the SF-36 Health Survey was administered to 60 patients with one of these clinical conditions (30 in each group; the patient group factor), matched for gender, and homogenized regarding age and working status. All renal patients had undergone transplantation 6 months before the first assessment, and all neurological patients presented a relapsing-remitting course and a mild-moderate disability level. Both patient groups were assessed a second time 6 months later (the phase factor). A mixed analysis of covariance was computed controlling for age as a covariate. Cohen's d was reported as an effect size index and to analyze the clinical significance regarding a representative age-adjusted sample of the general Spanish population (n = 5821).
  
  
  RESULTS
  Statistically significant differences were found between patient groups in vitality, bodily pain, social functioning, and mental health (P < .01), in which worse levels were displayed by patients with multiple sclerosis in both phases (Cohen's ds1-2 from 0.61 to 1.40). Likewise, an interactive effect was observed in physical functioning [F(1,57) = 12.93; P = .001], such that the performance of daily physical activities improved in renal recipients after 6 months, but it decreased in neurological patients. Patients with multiple sclerosis showed higher, clinically significant impairment in all SF-36 dimensions in both phases compared with renal recipients (Cohen's ds2-3 from -0.50 to -1.61), who presented clinically significant impairment in general health, role-physical, and role-emotional (Cohen's ds1-3 from -0.73 to -1.28).
  
  
  CONCLUSIONS
  Renal transplant recipients need specialized health care 1 year after transplantation because they still display relevant impairment in daily functioning compared with the general population.
authors: Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatments, University of Seville, Spain. Electronic address: eduferjim2@us.es.
authors: E
authors: E
authors: Fernández-Jiménez
authors: M A
authors: MA
authors: Pérez-San-Gregorio
authors: A
authors: A
authors: Martín-Rodríguez
authors: J
authors: J
authors: Pérez-Bernal
authors: G
authors: G
authors: Izquierdo
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents