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  • Cajochen, Christian  (3)
  • 2010-2014  (3)
  • 1
    In: Clinical Transplantation, Wiley, Vol. 28, No. 1 ( 2014-01), p. 58-66
    Abstract: The aims of this study were to determine the prevalence of immunosuppressive non‐adherence ( NA ) in renal transplant patients and describe whether the degree of daytime sleepiness ( DS ) and depressive symptomatology are associated with immunosuppressive NA . Methods Using a cross‐sectional design, 926 home‐dwelling renal transplant recipients who were transplanted at one of three Swiss transplant centers provided data by self‐report. The Basel Assessment of Adherence Scale for immunosuppressive was used to measure the following: taking, timing, and overall NA to immunosuppressive medication. DS was assessed with the Epworth Sleepiness Scale ( ESS ) (cut‐off ≥6 for DS ) and the Swiss Transplant Cohort Study DS item (cut‐off ≥4 for DS ), and depressive symptomatology was assessed with the Depression, Anxiety, and Stress Scale (cut‐off 〉 10). An ordinal logistical regression model was applied for statistical analysis. Results The prevalence of the ESS‐ DS was 51%. NA for taking, timing, and the median overall NA level assessed by 0–100% visual analog scale ( VAS ) was 16%, 42%, and 0%, respectively. Based on the multivariate analysis, DS was significantly associated (p  〈  0.001) with taking (1.08 [1.04–1.13]), timing (1.07 [1.03–1.10] ), and overall NA (1.09 [1.05–1.13]). Very similar results were found for the Swiss Transplant Cohort Study DS item. Conclusion DS is associated with immunosuppressive medication NA in renal transplant recipients. Admittedly, the association's strength is limited.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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  • 2
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2013-12)
    Abstract: Poor sleep quality (SQ) and daytime sleepiness (DS) are common in renal transplant (RTx) recipients; however, related data are rare. This study describes the prevalence and frequency of self-reported sleep disturbances in RTx recipients. Methods This cross-sectional study included 249 RTx recipients transplanted at three Swiss transplant centers. All had reported poor SQ and / or DS in a previous study. With the Survey of Sleep (SOS) self-report questionnaire, we screened for sleep and health habits, sleep history, main sleep problems and sleep-related disturbances. To determine a basis for preliminary sleep diagnoses according to the International Classification of Sleep Disorders (ICSD), 164 subjects were interviewed (48 in person, 116 via telephone and 85 refused). Descriptive statistics were used to analyze the data and to determine the frequencies and prevalences of specific sleep disorders. Results The sample had a mean age of 59.1 ± 11.6 years (60.2% male); mean time since Tx was 11.1 ± 7.0 years. The most frequent sleep problem was difficulty staying asleep (49.4%), followed by problems falling asleep (32.1%). The most prevalent sleep disturbance was the need to urinate (62.9%), and 27% reported reduced daytime functionality. Interview data showed that most suffered from the first ICSD category: insomnias. Conclusion Though often disregarded in RTx recipients, sleep is an essential factor of wellbeing. Our findings show high prevalences and incidences of insomnias, with negative impacts on daytime functionality. This indicates a need for further research on the clinical consequences of sleep disturbances and the benefits of insomnia treatment in RTx recipients.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2013
    detail.hit.zdb_id: 2041348-8
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  • 3
    In: Progress in Transplantation, SAGE Publications, Vol. 23, No. 3 ( 2013-09), p. 220-228
    Abstract: Daytime sleepiness in kidney transplant recipients has emerged as a potential predictor of impaired adherence to the immunosuppressive medication regimen. Thus there is a need to assess daytime sleepiness in clinical practice and transplant registries. Objective To evaluate the validity of a single-item measure of daytime sleepiness integrated in the Swiss Transplant Cohort Study (STCS), using the American Educational Research Association framework. Methods Using a cross-sectional design, we enrolled a convenience sample of 926 home-dwelling kidney transplant recipients (median age, 59.69 years; 25%-75% quartile [Q25-Q75], 50.27–59.69), 63% men; median time since transplant 9.42 years (Q25-Q75, 4.93–15.85). Daytime sleepiness was assessed by using a single item from the STCS and the 8 items of the validated Epworth Sleepiness Scale. Receiver operating characteristic curve analysis was used to determine the cutoff for the STCS daytime sleepiness item against the Epworth Sleepiness Scale score. Results Based on the receiver operating characteristic curve analysis, a score greater than 4 on the STCS daytime sleepiness item is recommended to detect daytime sleepiness. Content validity was high as all expert reviews were unanimous. Concurrent validity was moderate (Spearman ϱ, 0.531; P 〈 .001) and convergent validity with depression and poor sleep quality although low, was significant (ϱ, 0.235; P 〈 .001 and ϱ, 0.318, P= .002, respectively). For the group difference validity: kidney transplant recipients with moderate, severe, and extremely severe depressive symptom scores had 3.4, 4.3, and 5.9 times higher odds of having daytime sleepiness, respectively, as compared with recipients without depressive symptoms. Conclusion The accumulated evidence provided evidence for the validity of the STCS daytime sleepiness item as a simple screening scale for daytime sleepiness.
    Type of Medium: Online Resource
    ISSN: 1526-9248 , 2164-6708
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2864264-8
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