To investigate the coping styles, medication adherence and self-management of kidney transplant recipients, and to explore the predictive effects of coping styles on adherence to medication and self-management.

Convenience sampling was used to recruit 125 kidney transplant recipients (kidney transplant patients group) at the clinic of the Third Affiliated Hospital of Guangzhou Medical University. All recipients completed general information sheet, medical coping modes questionnaire (MCMQ), basel assessment of adherence with immunosuppressive medication scale (BAASIS) and the kidney transplant recipients self-management scale. Data were collected during recipients′ follow-ups. Hierarchical regression was conducted to examine the predictive effects of coping styles on adherence to medication and self-management. Both variance inflation and tolerance values were examined for the possible presence of multicollinearity. A P value less than 0.05 was considered statistically significant.

Kidney transplant recipients scored highest in confrontation (19.8±2.9). Avoidance scores in kidney transplant patients group was (15.1±2.7) which was differed from the chronic disease norm group (14.4±3.0) (t=-2.320, P<0.05). Kidney transplant recipients scored (22.2±2.6) in BAASIS, 53 cases (42.4%) showed good medication adherence; 36 (27.9%) recipients had missed at least one dose of immunosuppressants in the past month; 19 recipients (15.2%) had at least one consecutively missed drugs in the past month; 63 recipients (50.4%) had taken drugs 2 hours earlier or later in the pat month; 9 recipients (7.2%) had not taken medicine according to doctor′s advice. The total score of self-management was (91±8), 68 (54.5%) recipients had good self-management and 57 (45.6%) recipients had moderate self-management. The scores of diet, treatment, physical activity and psychosocial management were (29.5±3.0), (33.4±3.4), (15.7±2.1) and (12.4±1.6), respectively. Coping styles variables, including confrontation, avoidance and resignation added 8.6% explained variances to medication adherence, 13.7% explained variances to treatment management, 7.0% explained variances to physical activity management, 25.0% explained variances to psychosocial management, and 15.0% explained variances to overall self-management, respectively. Hierarchical regression analyses suggested that resignation (β=-0.252, P<0.01) was significant predictor of medication adherence; confrontation was significant predictor for diet management (β=0.212, P<0.05), treatment management (β=0.348, P<0.01) , physical activity management (β=0.255, P<0.01) and the overall self-management (β=0.365, P<0.01); the significant predictors of psychosocial management were confrontation and resignation (β=0.394 and -0.271, P<0.01).

The coping styles of kidney transplant recipients had a significant influence on both adherence to medication and the self-management recommendations. In order to improve medication adherence and the level of self-management among kidney transplant recipients, health professions need to pay more attention to the coping strategies used and alter their negative copings timely.