title: Young Adult Kidney Transplant Recipients: Nonadherent and Happy.
abstract: BACKGROUND
  The aim of this study was to investigate (a) the extent to which age at first renal replacement therapy, achievement of developmental milestones, satisfaction of psychological needs, and coping were related to subjective well-being and medication adherence among young adult kidney transplant recipients; and (b) the relationship between subjective well-being and immunosuppressive medication adherence.
  
  
  METHODS
  A cross-sectional, interview study was conducted among renal transplant patients aged 20 to 30 years. In addition to sociodemographic and medical characteristics, concepts measured were: subjective well-being (Positive And Negative Affect Schedule; Satisfaction With Life Scale), medication adherence (Basel Assessment of Adherence to Immunosuppressive Medication Scale), dispositional coping (Brief COPE), achievement of developmental milestones (Course of Life Questionnaire), and satisfaction of psychological needs (Basic Psychological Needs Scale).
  
  
  RESULTS
  Sixty-two patients participated (66% men; mean age, 26 years). Sixty-five percent were classified as nonadherent in the past month. In contrast, subjective self-rated overall adherence was high. None of the variables measured were related to nonadherence. Higher feelings of competence and autonomy, and timely achievement of social and psychosexual developmental milestones were related to higher subjective well-being. Well-being and adherence did not differ according to age at diagnosis or first renal replacement therapy.
  
  
  CONCLUSIONS
  Two thirds of participants were classified as nonadherent which conflicts with participants' own high rating of medication adherence. This emphasizes the need for continued adherence support among young adult transplant recipients; however, no targets for interventions were found in this study. Potential targets for interventions aimed at improving well-being include competence and autonomy.
authors.affiliation: 1 Department of Internal Medicine, Section Nephrology & Kidney Transplant, Erasmus MC, Rotterdam, the Netherlands. 2 Department of Paediatric Nephrology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Emma K
authors.initials: EK
authors.lastname: Massey
authors.forename: Karlijn
authors.initials: K
authors.lastname: Meys
authors.forename: Roy
authors.initials: R
authors.lastname: Kerner
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.forename: Joke
authors.initials: J
authors.lastname: Roodnat
authors.forename: Karlien
authors.initials: K
authors.lastname: Cransberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D006240:Happiness; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D055118:Medication Adherence; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D066027:Transplant Recipients / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents