Academic journal article Journal of Behavioural Sciences

The Journey from Illness to Wellness: An Exploration of Sociocultural Issues after Renal Transplantation in Pakistan

Academic journal article Journal of Behavioural Sciences

The Journey from Illness to Wellness: An Exploration of Sociocultural Issues after Renal Transplantation in Pakistan

Article excerpt

Transplantation is a major physical surgical experience with both physical and psychological consequences that influence the recipient's adjustment and coping in a specific society and culture. The aim of transplant is to improve the quality and quantity of life in individuals with organ failure. Researches focusing the evaluation of recipients' satisfaction with health outcomes of transplantation mainly assess their objective and subjective Quality of Life (QoL). Objective QoL is mostly evaluated by health outcomes, whereas subjective QoL involves individual's perception of life after transplant. Theoretical perspectives on quality of life attempt to describe it as a multidimensional concept comprising of separate domains including physical, mental, social and economic components. The World Health Organization (W.H.O) defines it as an individuals' perception of their position in life in the context of the culture and the value system in which they live, thus referring to the significance of the cultural determinants influencing QoL (Dodge, Daly, Huyton, & Sanders 2012). Organ transplantation is a process that needs to be perceived in the context of prevailing cultural, religious and socioeconomic conditions in a specific country. Pakistan is one of the developing countries that has the largest centers for commercial renal transplantation. Legislation on organ donation has regulated this practice, ultimately reducing the rate of organ trade in conformity with international guidelines (Bile et al., 2010). However, the sociocultural barriers in the transplantation process still await attention in Pakistan.

The sociocultural transplant experience model is a conceptual model which organizes the significant sociocultural factors that may influence the transplant process. Since the transplant population is extremely diverse, therefore, there is a need for a model addressing sociocultural issues implicated in the transplant related health outcomes. This conceptual model attempts to facilitate the transplant teams and care givers to attend to sociocultural influences associated with the transplant experience (Maloney, Clay, & Robinson, 2000). Future work needs to investigate its utility and validate the influence of the identified sociocultural variables on recipients' physical and psychological wellbeing.

This model provides a theoretical model that identifies and discusses the significance of sociocultural factors implicated in the transplant experience. The model focuses on the role and significance of sociocultural factors in disease onset, course of illness, treatment acceptability, health and religious beliefs, adherence, health outcomes, adjustment and functioning after transplant. It also highlights the fact that mostly the psychosocial consequences are discussed without consideration of sociocultural underpinnings influencing recipients coping strategies and overall quality of life. Research examining psychological implications of transplant need to consider favorable as well as adverse physical and psychosocial health outcomes (i.e. patient and family sociocultural factors, assessment or treatment provisions, physical and psychosocial health outcomes) in order to clarify if organ rejection and graft loss occurs due to non-adherence is mainly influenced by psychosocial factors. This would help in designing interventions designed to deal with prospective risk factors such as non-adherence which are culturally incongruent for some families (Maloney et al., 2000).

Sociocultural factors implicated in the process of transplant are focused in this theoretical framework that include sex, age, race, ethnicity, socioeconomic status, sexual orientation, spirituality and religion, residential factors, disability, language etc. for variability in health outcomes and overall Quality of Life (QoL) (Maloney et al., 2000).

According to this model, the transplant process comprises of four key phases. These phases begin with assessment of the prospective recipient as a potential candidate, then focuses on the issues prior to transplantation such as waiting, transplantation and hospitalization, and finally what happens after post-transplantation and later the adjustments and requirements of post-hospitalization. …

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