Masters Theses

Date of Award

5-1989

Degree Type

Thesis

Degree Name

Master of Science

Major

Nursing

Major Professor

Sandra Thomas

Committee Members

Mary Lue Jolly, John Jozwiak

Abstract

The option of kidney transplantation Is one that most hemodialysis patients will consider at some time during their course of treatment. It requires all the resources and personal ability of the person making the decision. This study was undertaken to explore the influence of social support on decision for transplantation in dialysis patients.

Past research has shown a strong inverse relationship between social support and stress. The literature supports the relationship of social support as a stress reducer and the relationship of the decision to stress. Decision-making is required during times of stress. According to Lazarus and Folkman (1984), after encountering a stress, most persons decide to take no action, or decide on a course of action.

Forty-five dialysis patients were asked to fill out the Norbeck Social Support Questionnaire. They were then divided Into two groups—a group choosing transplantation and a group deciding against transplantation. The results indicated that the patients were almost always In agreement with their social networks' decision for transplantation. The majority (15 of 22) of subjects in the "yes" group (those who had opted for transplant) had 100 percent network agreement with their decision. In contrast, among subjects in the "no" group (those who had not chosen transplant), the majority (16 of 23) reported that their network members were undecided. In every aspect, the scores on the Norbeck instrument for social networks of the "yes" transplant group were higher than the "no" transplant group. Specifically, scores on the ability to make one feel liked, loved, esteemed, or valued V (affect) were much higher for persons choosing transplantation.

Size of network, age, Income, marital status, length of stay on dialysis, and education were not significantly different between the "yes" and "no" transplant groups. However, the person In the "yes" transplant group was found to have been on dialysis for a mean of 28 months as opposed to 45 months In the "no" transplant group. Although not statistically significant, the difference was large enough to suggest a possible optimum time for decision on transplantation.

White women were three times more likely to choose transplantation than White men. Black males and females were equally likely to choose transplantation. However, 63 percent of the Blacks In this study chose transplantation as opposed to 40 percent of the Whites. In light of the strong agreement between the patient's decision and his network's decision for transplantation, and stronger social support in the "yes" transplant group. It Is possible that lower socio-economic White males have weaker social support structures than White females or Blacks. Recommendations for nursing practice and future research were offered.

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