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The Influence of Illness Burden and Social Support on the Completion of Kidney Transplant Evaluation

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Lim , Crystal (2015) The Influence of Illness Burden and Social Support on the Completion of Kidney Transplant Evaluation. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Kidney transplantation is the preferred method of treatment to dialysis for end stage renal disease (ESRD) because of its many proven benefits over dialysis treatment. Patients interested in kidney transplantation must undergo a kidney transplant (KT) evaluation to determine their medical and psychosocial eligibility. A timely completion of the KT evaluation is critical for prompt listing for or the receipt of a KT. However, ESRD patients suffer from significant illness burden that interferes in their participation of life activities, which can affect their completion of KT evaluations. At the same time, the presence of social support is known to abate symptom burden and the perception of illness burden. This implies that social support has the potential to facilitate completions of KT evaluations by moderating illness burden.
This novel study is the first to examine how social support buffers illness burden in affecting KT evaluation completion. This quantitative study involves 1,130 study participants recruited from the Starzl Transplant Institute of University of Pittsburgh Medical Center. The goals of this study are 1) to understand how demographic factors (age, gender, race and income), illness burden and social support independently affects time taken to complete KT evaluation, and 2) to assess how these factors interact in influencing time to complete KT evaluation.
The hypothesis that social support buffers illness burden in the completion of KT evaluation was not supported. Instead social support demonstrated main effects on the completion of KT evaluation: higher level of perceived social support was associated with a higher rate of KT evaluation completion. Older age, lower income, African American race and greater illness comorbidity were associated with lower KT evaluation completion rates. Limitations of the study include: a single-center study with non-random patient participation, a limited examination of social network based on network size, and the violation of proportionality of hazard assumption in the Cox regression analysis.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Lim , Crystalcrystalimay@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairNewhill, Christinanewhill@pitt.eduNEWHILL
Committee CoChairMyaskovsky, Larissamyaslx@upmc.edu
Committee MemberCopeland, Valiresswvcc@pitt.eduSSWVCC
Committee MemberRauktis, Mary E.mar104@pitt.eduMAR104
Date: 12 January 2015
Date Type: Publication
Defense Date: 29 August 2014
Approval Date: 12 January 2015
Submission Date: 11 January 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 131
Institution: University of Pittsburgh
Schools and Programs: School of Social Work > Social Work
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: illness burden, social support, social network, transplant evaluation, kidney transplant
Date Deposited: 12 Jan 2015 13:39
Last Modified: 15 Nov 2016 14:26
URI: http://d-scholarship.pitt.edu/id/eprint/23945

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