CORRELATES OF NONCOMPLIANCE AMONG RENAL-TRANSPLANT RECIPIENTS

The purpose of this study was to identify variables that are associate d with noncompliance among adult renal transplant recipients, includin g demographic characteristics, transplant-related variables, and psych osocial factors. The measurement of noncompliance was improved by asse ssing noncompliant behaviors (i.e., noncompliance with medications and the follow-up regimen) prior to the onset of complications and/or gra ft loss and by measuring compliance as a continuous rather than dichot omous variable. Two-hundred-and-forty-one renal transplant recipients completed the Beck Depression Inventory, the anxiety and hostility sub scales of the Brief Symptom Inventory, the Multidimensional Health Loc us of Control Scale, the Inventory of Socially Supportive Behaviors, t he Coping Strategies Inventory, a measure of transplant-related stress ors, and self-report measures of compliance with medications and the f ollow-up regimen. Approximately half of our sample reported at least s ome degree of noncompliance. Recipients who were younger, female, unma rried, retransplanted, and with lower incomes tended to be noncomplian t with medications (all p's<0.05). Recipients who were unmarried, low income, not insulin-dependent, and with a longer time since transplant tended to be noncompliant with the follow-up regimen. In addition, re cipients who reported higher stress and more depression, who coped wit h stress by using avoidant coping strategies, and who believed that he alth outcomes are beyond their control were less compliant with both m edications and follow-up (all p's<0.05). Regression analyses revealed that stress was the strongest predictor of both medication and follow- up compliance.