Health and Treatment-Related Anxiety among Kidney Transplant Recipients in Kazakhstan

Background: Kidney transplantation (KTx) is a life-saving intervention, but post-transplant psychological well-being and treatment adherence remain critical challenges. This study aimed to (1) develop and validate a Health and Treatment-Related Anxiety Scale in Kazakh- and Russian-languages, (2) identify predictors of such anxiety, and (3) examine its impact on adherence to treatment and well-being among kidney transplant recipients in Kazakhstan.
Methods: A cross-sectional study was conducted among 223 adult kidney transplant recipients. The newly developed anxiety scale was tested for psychometric validity using exploratory and confirmatory factor analyses. Internal consistency and criterion-related validity were assessed through item-rest correlations and correlation with related outcomes. Multiple linear regression and mediation models were used to identify predictors of health and treatment-related anxiety and psychological mechanisms affecting treatment adherence and well-being.
Results: The scale demonstrated strong psychometric properties with a one-factor structure and high internal consistency (Cronbach’s α=0.893). Anxiety negatively correlated with both treatment adherence (p<0.001). Regression analysis identified employment under disability status and perceived availability of post-KTx monitoring as protective factors. Emotional support and anxiety levels significantly predicted treatment adherence. Mediation analyses revealed that anxiety partially mediated the relationship between perceived post-KTx monitoring and both adherence and well-being (p<0.05).
Conclusion: The validated anxiety scale is a reliable tool for assessing psychological vulnerability in kidney transplant recipients. Addressing treatment-related anxiety may enhance post-transplant care by improving both adherence and emotional well-being.