Goal disturbance and perceived control pre-post renal transplantation relate to distress changes: a longitudinal study

Abstract

Background: Renal transplantation (RTx) is considered the treatment of choice for End Stage Renal Disease (ESRD) given its association with improved overall quality of life and psychological functioning compared to dialysis. However, less is known about which factors underlie these psychological improvements across RTx. Goal theory suggests that experienced disturbances in important goals are related to lower psychological functioning. This study aimed to (1) identify the most important and disturbed goals for patients before RTx, (2) to examine changes in goal disturbance and goal importance pre-post RTx, and (3) to examine whether changes in goal disturbance are associated with changes in psychological distress, and if this relationship is mediated by changes in perceived control. Methods: In this longitudinal study, 185 patients completed questionnaires before and after RTx, including a GOALS questionnaire, General Health Questionnaire to measure psychological distress, and Mastery scale to measure perceived control. Paired samples t-tests were used to analyze pre-post RTx changes. Unique predictive effects of pre-post RTx changes in goal disturbance and perceived control on distress changes were analyzed with hierarchical regression analyses. Findings: ESRD affected both general and disease specific life goals. Goal disturbance generally decreased significantly pre-post RTx, whereas goal importance did not change significantly. No mediation effect of perceived control was found. Instead, both changes in goal disturbance and perceived control independently showed a significant main effect on changes in distress. Discussion: The development of intervention strategies targeting goal disturbance or perceived control in ESRD patients might enhance psychological functioning in this population.