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Déterminants et évolution de profils de qualité de vie et d’adhésion aux traitements : analyse dans une cohorte de patients transplantés rénaux

Abstract : In parallel to clinical and biological factors, many psychological determinants could influence transplant patient grafts survival and contributes to patients’ morbidity and mortality. Among them, adherence and quality of life were largely reported. In this context, our objective was to study, in kidney transplant patients, quality of life and adherence time-profiles heterogeneity and to identify determinants of distinct time-course. First, we identified two homogeneous subpopulations of patients: a majority presented a quality of life similar to the general population, while 40% of patients showed a poor quality of life associated with more episodes of anxiety and muscle weakness. Secondly, we found two distinct adherence time-profiles: the majority of patients were adherent while 15% presented a non-adherence constantly increasing associated with a poor mental quality of life and more depressive episodes. Finally, we proposed in this work a new tool dedicated to the evaluation of adherence in French-speaking transplant patients. This thesis provides new tools, easy to use even early on after transplantation, to detect patients with poor quality of life and / or adhesion in order to individualize the management of these patients with appropriate interventions.
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Claire Villeneuve. Déterminants et évolution de profils de qualité de vie et d’adhésion aux traitements : analyse dans une cohorte de patients transplantés rénaux. Médecine humaine et pathologie. Université de Limoges, 2016. Français. ⟨NNT : 2016LIMO0053⟩. ⟨tel-01452926⟩

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