Health  Vol.7 No.5 , May 2015
A Questionnaire Survey in Kidney Transplant Outpatients: Factors Associated with Good Self-Management
Abstract: It is very important for outpatients who have had a kidney transplant to take care of themselves after discharge. However, outpatients have limited access to medical care by hospital staff after discharge; therefore, medical staff are unaware of the patient’s living conditions, and the uncertainties and problems that they encounter related to self-management. We conducted a questionnaire survey among 161 of 200 outpatients who received kidney transplants to investigate their recognition and actual practice of daily self-management. To determine the characteristics of adherent outpatients, we divided patients into two groups (the adherent and non-adherent group) and compared them. The Chi-squared test was conducted to test the equality of proportions among the groups, and then multiple logistic regression analysis was used to explore the factors significantly associated with regularly taking medicine or failing to take medicine. As a result of the logistic regression model using demographic factors as independent factors, the periods after transplantation (2 - 5 and 5 - 10 years) and living-donor kidney transplantation or cadaveric kidney transplantation were selected as significant factors associated with good self-management. As a whole, 68.3% of the 145 patients were correctly predicted using the model. The results of this study suggest that in the short period after transplantation (2 - 5 years), cadaveric kidney transplantation and that the patient has a job are significant factors associated with good self-management. Behind these results, a unique Japanese concept, “amae”, could be found. Therefore, medical knowledge and techniques as well as cultural background should be studied.
Cite this paper: Shimaya, M. , Watanabe, M. , Azumi, M. , Shichiri, K. , Tomiyama, C. , Tanabe, M. , Sato, S. and Akazawa, K. (2015) A Questionnaire Survey in Kidney Transplant Outpatients: Factors Associated with Good Self-Management. Health, 7, 589-595. doi: 10.4236/health.2015.75070.

[1]   Inoue, H., Takayanagi, T., Suzuki, A., Sato, S., Hirokawa, I., Kawaji, K. and Ikoma, F. (1956) Experience with Renal Homotransplantation in the Human: A Case of Mercury Bichloride Intoxication. The Japanese Journal of Urology, 47, 857-886.

[2]   The Japan Society for Transplantation, Japanese Society for Clinical Renal Transplantation (2014) Annual Progress Report from the Japanese Renal Transplant Registry: Number of Renal Transplantation in 2013 and Follow-Up Survey. The Japan Society for Transplantation, 49, 240-260.

[3]   The Japan Society for Transplantation.

[4]   Kadowaki, M., Saito, M., Amada, N., Haga, I., Nakamura, A. and Tokodai, K. (2014) Medication Compliance in Renal Transplant Patients during the Great East Japan Earthquake. Transplantation Proceedings, 46, 610-612.

[5]   Nevins, T.E., Kruse, L., Skeans, M.A. and Thomas, W. (2001) The Natural History of Azathioprine Compliance after Renal Transplantation. Kidney International, 60, 1565-1570.

[6]   Morrissey, P.E., Reinert, S., Yango, A., Gautam, A., Monaco, A. and Gohh, R. (2005) Factors Contributing to Acute Rejection in Renal Transplantation: The Role of Noncompliance. Transplantation Proceedings, 37, 2044-2047.

[7]   University of Maryland Medical Center (2015) Living Donor Kidney Transplant Program.

[8]   Japan Organ Transplant Network Homepage (2015)

[9]   Doi, T. (1981) The Anatomy of Dependence: The Key Analysis of Japanese Behavior. 2nd Edition, Kodansha International, Tokyo.

[10]   Johnson, F.A. (1992) Dependency and Japanese Socialization: Psychoanalytic and Anthropological Investigations in Amae. New York University Press, New York.

[11]   Gibney, F. (1975) Japan: The Fragile Superpower. Norton.