Racial and Gender Differences in Quality of life Following Kidney Transplantation

PURPOSE: To determine if race or gender affected changes in quality of life (QoL) reported by nondiabetic kidney transplant recipients from pre- to 6 and 12 months post-transplant and offer possible explanations. Information gained may offer direction for interventions designed to enhance post-transplant QoL for patients who may be less likely to attain improved outcomes. DESIGN: Descriptive, prospective clinical study. A convenience sample of 90 male and female Caucasian-American and African-American patients was used. Patients were 19 to 67 years of age, nondiabetic, and undergoing kidney transplantation at one university hospital located in the southern United States. Data were collected 1990 to 1995. METHODS: Three questionnaires measuring QoL were used: the Sickness Impact Profile, Ferrans and Powers' Quality of Life Index, and the Adult Self-Image Scales. Patients completed questionnaires at the time of transplant and at their routine 6- and 12-month post-transplant evaluation visits. Repeated measures analysis of variance with multiple pre-planned comparisons of least-squares (LS) means were performed to determine if differences existed between and within study groups over time. FINDINGS: African-Americans achieved less improvement than Caucasian-Americans in affective as well as functional measures of QoL. Women scored consistently lower than men on most QoL measures at baseline and reported greater improvement in functional ability while perceptions of self-image remained low. CONCLUSIONS: Although transplantation dramatically improves QoL, some segments of the patient population, namely African-Americans and women, do not benefit to the same extent as others. Nurses need to recognize sociocultural differences in patients and how these differences affect care requirements.