The Relationship Between the Sick Role and Functional Ability: One Center's Experience

Objective: To determine the impact of the sick role on posttransplant functional ability.

Methods: A convenience sample of 97 kidney transplant recipients (mean age, 45.8 years; SD, 12.8 years; 47% female; 68% African American) participated in this exploratory cross-sectional study. Self-report data were collected during a posttransplant clinic visit via the Response to Illness Questionnaire used to measure sick-role perceptions, the Functional Status Questionnaire used to measure functional ability, and an investigator-developed Demographic Data Sheet used to measure sociodemographic data and comorbidities.

Results: Factor analysis of the Response to Illness Questionnaire yielded 7 distinct factors that accounted for 62.2% of total score variance. Multiple regression analysis indicated a significant relationship between those 7 factors and the 5 factors revealed by the Functional Status Questionnaire. Demographic factors that also correlated with the functional status factors included type of work, gender, age, education, and donor source. Coping with illness and Resentment of illness were the strongest predictors of functional status in this sample. Patients with the strongest coping skills and the least resentment of illness consistently showed more advanced functional abilities.

Conclusions: Results suggest that individuals who have the strongest coping skills and the least resentment toward their illness seem best able to gain strength and reject the sick role as a permanent identity. Health care providers must acknowledge patients' illness perceptions and design interventions focused on optimizing functional ability in vulnerable transplant recipients.