Psychological Factors of Quality of Life in Renal Transplant Recipients: A Longitudinal Study of Bi-Directional Relationships

Improved Quality of life (QoL) encompassing clinical and psychological aspects is the goal of research in solid organ transplantation. Assessment of treatment efficacy is based on subjective evaluations of actual health status, physical functioning, life satisfaction and psychological wellbeing in this population. A longitudinal study was carried out to test bi-directional relationships between psychological factors and QoL in renal transplant recipients (RTRs) over a period of two years. The psychological aspects included their perceived health status, life orientation (optimism), depression, and conscientiousness. The aim was to analyze the extent to which psychological factors influence QoL and the directionality of the influence. The preliminary analysis revealed that overall psychological factors significantly correlate with QoL. The findings of cross lagged analysis yielded a mixed pattern of relationships at waves 1, 2 and 3 indicating the existence of bi-directionality of the relationships between QoL and the psychological factors. A reciprocal relationship between depression and QoL was found whereas QoL predicted perceived health status and optimism at wave 3.  Conscientiousness did not correlate with QoL across waves. The findings provide insights into the role of psychological factors in identifying a pattern of overtime. The study highlights the role of psychological factors in QoL of RTRs and suggests their monitoring and inclusion in the post-transplant management.