Illness behaviour in live-related and cadaver renal transplant recipients

Illness behaviour was compared in 10 biologically live-related and 30 cadaver renal donor recipients in respect of their long-term psychological adjustment. The results indicated few long-term statistically significant differences postoperatively in illness behaviour between the two groups of patients, but a factor analysis revealed 8 items that were significantly related to illness behaviour associated with post-transplant psychological adjustment for all 40 transplantees studied. These were feelings of inadequacy; the renal graft being 'alien'; an inability to cope with the transplant; the disease resulting in the transplant being an external imposition beyond their control; responsibility for and acceptance of the transplant as a 'gain'; culpability for what has happened to them; anxious preoccupation with long-term prognosis; and dependence on others. Further analysis of these findings and their relevance for optimal patient management are discussed. Appropriate psychological support for these patients is important and, although long-term illness behaviour of biologically live-related and cadaver-related renal transplant recipients was found to be relatively similar, the various issues related to post-transplant illness behaviour in both groups of patients should be addressed in the provision of a psychonephrology service to a renal unit.