Les expériences de maintien en emploi au travers de la trajectoire de transplantation rénale : une description qualitative
Following kidney transplantation, employment predicts patient quality of life and decreases mortality and graft loss greffon (Chisolm et al., 2015; Prihodova et al., 2015). Yet, a majority of able kidney recipients are unemployed (Slakey & Rosner, 2007). Amongst the possible explanatory factors, employment during dialysis is a robust predictor of return to work after transplantation (van der Mei et al., 2006). In this regard, the development of efficient support systems aimed at keeping patients with chronic diseases in the workforce requires a thorough understanding of their needs and concerns (Vooijs et al., 2017). However, end-stage-kidney-disease patients’ perspectives regarding job retention remain poorly documented. This study thus aims to describe patients’ experiences of labour participation before and after kidney transplantation. A descriptive qualitative research design was adopted (Sandelowski, 2000). Patients with end-stage-kidney-disease who recently underwent transplantation were recruited one to twelve months post-transplant at a university-affiliated hospital in a large urban area. They were interviewed about their illness and work experiences using a semi-structured interview schedule. Based on employment status, 31 of those interviews were selected and were subjected to thematic analysis (Braun & Clarke, 2006; Patton, 2015). Three themes emerged from the data: (1) struggling to establish a satisfactory routine that balances work and illness demands as well as patient involvement in other life domains, (2) becoming aware of personal limits due to a decline in work capacity which leads to needing support from others, and (3) being motivated to stay at work by cultivating positive perceptions about work and by undertaking targeted actions. These results suggest possible interventions aimed at job maintenance for kidney transplant patients such as supporting patient adjustment during employment transitions, encouraging dialogue with employers, and supporting the use of self-management strategies adapted to their work schedules. Limits of the present study include a lack of diversity in recruitment sites and the absence of an iterative process during data collection. Future studies could be conducted in rural or private care settings and examine the long-term employment adjustment of transplant recipients.
transplantation étude qualitative employment kidney disease qualitative study chronic illness activities of daily living work-life balance self-management activity limitations