Comprehension and Expectations

An assessment of the patient's and family's knowledge of the transplant procedure, attitude toward transplant, and level of motivation for transplant is crucial to evaluating psychological preparedness for transplantation. Factors such as knowledge about the illness and its medical treatment, belief in its treatment, positive personal meaning attributed to the illness, and therapeutic motivation for treatment have been correlated with improved adherence rates in adolescents with chronic illnesses (Kyngas et al. 2000). A study comparing self-regulation predictors of medication adherence demonstrated that a subset of pediatric renal transplant recipients who were motivated to be medication adherent and perceived control over their own adherence were more likely to adhere to their therapeutic treatments (Tucker et al. 2001). In an early study that investigated the association between hope and emotional adjustment in children with chronic illness, higher levels of self-reported hope were correlated with improved coping strategies and ultimately with improved adjustment to illness (Lewis and Kliewer 1996). More recently, the association between hope and rates of treatment adherence was found to be mediated by symptoms of depression in pediatric renal and liver transplant recipients (Maikranz et al. 2007).

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