title: Cooperation in Treatment as an Indicator of Adaptation of Kidney Transplant Patients to Chronic Therapy.
abstract: BACKGROUND
  Cooperation between patients and physicians in chronic treatment is an important factor in the patients' adaptation to difficult circumstances. The search is ongoing for factors important to the physician-patient relationship, with the goal of identifying deficits and psychological resources of the patients and medical soft skills of the physicians that can affect the quality of cooperation. The aim of this study was to analyze the psychological mechanisms of patient cooperation with physicians in the area of treatment after kidney transplantation.
  
  
  METHODS
  The study group consisted of 105 patients (62 male patients and 43 female patients) aged 25 to 82 years (mean age, 50.91 years) after kidney transplantation who remained in the follow-up protocol of the Outpatient Transplant Clinic. A questionnaire was used to examine the compatibility of ratings as expressed by the patients and their physicians in 10 areas of cooperation in treatment. The tests for a sense of self-efficacy (General Self-Efficacy Scale), optimism (Life Orientation Test-Revised), and the control of emotions (Courtauld Emotional Control Scale) in Juczyński's adaptation were used in the study of psychological factors.
  
  
  RESULTS
  Only 1 case reached total congruity by the patients and their physicians in all 10 areas of cooperation. In 3 areas, compliance was achieved in 70%, 72%, and 76%, respectively; in 6 areas, 50% to 66%; and in 1 sphere, 37%. We found no significant impact of psychological factors on patient compliance. A comparison was made of 2 groups of patients (1 of which was characterized by a high compatibility between the physician and patient assessments, and the second which was characterized by the lack of conformity). Moreover, assessment of the functioning of the transplanted kidneys was rated higher in those patients who achieved a high compliance with the opinions of medical cooperation in the treatment.
  
  
  CONCLUSIONS
  The quality of cooperation measured by using compliance assessments of the patients and physicians in health behaviors is satisfactory. This finding translated into a favorable assessment of the functioning of the transplanted kidney expressed by the patients. Qualitative information provides guidance for targeted increasing collaboration.
authors: Chair and Department of Nephrology, Collegium Medicum Jagiellonian University, Krakow, Poland. Electronic address: bazawadzka@gmail.com.
authors: B
authors: B
authors: Zawadzka
authors: I(st) Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
authors: S
authors: S
authors: Zawadzka
authors: Chair and Department of Nephrology, Collegium Medicum Jagiellonian University, Krakow, Poland.
authors: W
authors: W
authors: Sułowicz
authors: Chair and Department of Nephrology, Collegium Medicum Jagiellonian University, Krakow, Poland.
authors: E
authors: E
authors: Ignacak
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D010817:Physician-Patient Relations; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult