Common Psychiatric Problems in the Well Transplant Patient

Nickels, Mark W.

doi:10.1177/152216280100400407

Cited by 6 publications

(5 citation statements)

References 40 publications

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“…For instance, after lung transplantation, emotional health and pain continue to be negatively affected 8,21. Furthermore, Nickels26 described the importance of detecting deficits in cognition in lung transplant recipients. Ongoing cognitive deficit may be due to thyroid and other metabolic abnormalities, nutritional deficiencies, and medication side effects.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcome 2 years after lung transplantation: does the underlying diagnosis matter?

Santana¹,

Feeny²,

Ghosh³

et al. 2012

PROM

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PurposeTransplantation has the potential to produce profound effects on survival and health-related quality of life (HRQL). The inclusion of the patient’s perspective may play an important role in the assessment of the effectiveness of lung transplantation. Patient perspectives are assessed by patient-reported outcome measures, including HRQL measures. We describe how patients’ HRQL among different diagnosis groups can be used by clinicians to monitor and evaluate the outcomes associated with transplantation.MethodsConsecutive lung transplant recipients attending the lung transplant outpatient clinic in a tertiary institution completed the 15-item Health Utilities Index (HUI) questionnaire on a touchscreen computer. The results were available to clinicians at every patient visit. The HUI3 covers a range of severity and comorbidities in eight dimensions of health status. Overall HUI3 scores are on a scale in which dead = 0.00 and perfect health = 1.00; disability categories range from no disability = 1 to severe disability <0.70. Single-attribute and overall HUI3 scores were used to compare patients’ HRQL among different diagnosis groups. Random-effect models with time since transplant as a random variable and age, gender, underlying diagnoses, infections, and broncholitis obliterans syndrome as fixed variables were built to identify determinants of health status at 2-years posttransplantation.ResultsTwo hundred and fourteen lung transplant recipients of whom 61% were male with a mean age of 52 (19–75) years were included in the study. Chronic obstructive pulmonary disease and cystic fibrosis patients displayed moderate disability, while pulmonary fibrosis and pulmonary arterial hypertension patients displayed severe disability. Patients with chronic obstructive pulmonary disease had the worst pain level, whereas patients with pulmonary fibrosis had the worst emotion and cognition levels. A random-effect model confirmed that development of broncholitis obliterans syndrome was the most important determinant of health status (P = 0.03) compared to other variables, such as cytomegalovirus infections and underlying diagnoses.ConclusionDescriptions of patients’ HRQL among different diagnosis groups could be used by clinicians to assist individualized patient care.

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Section: Discussionmentioning

confidence: 99%

Patient-reported outcome 2 years after lung transplantation: does the underlying diagnosis matter?

Santana¹,

Feeny²,

Ghosh³

et al. 2012

PROM

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“…«The role of a healthy transplant recipient can create expectations that may be challenged by a fluctuating health condition.» Some informants said that it could be difficult to share their concerns about side effects or other symptoms after the transplantation, which is consistent with other studies of kidney transplant recipients (8,9). The role of a healthy transplant recipient can create expectations that may be challenged by a fluctuating health condition.…”

Section: Side Effects Of Immunosuppressive Drugsmentioning

confidence: 53%

“…Such expectations can prevent recipients from sharing their concerns about organ rejection, infections and side effects of medication. They can also lead to concerns not being taken seriously (8,9).…”

Section: Side Effects Of Immunosuppressive Drugsmentioning

confidence: 99%

“…This requires new knowledge, new skills and, for some, new coping strategies (8,9). Amerena and Wallace (9) showed that kidney transplant recipients had conflicting experiences in the post-transplant period.…”

Section: After the Transplantationmentioning

confidence: 99%

“…These themes were the transition from life with a chronic illness to life after the transplantation, social relationships and follow-up after the transplantation. We chose these themes based on findings from studies of quality of life following a KPT (2,(5)(6)(7)10), transplant recipients' experiences (8,9,12) and clinical experiences from transplant surgical wards.…”

Section: Data Collectionmentioning

confidence: 99%

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Hverdagen etter nyre–pankreas-transplantasjon

Dahl¹,

Moen²

2017

Sykepleien

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Background: A successful kidney-pancreas transplantation (KPT) is the most effective treatment for patients with diabetes who develop late-stage chronic renal failure. Although studies show an improvement in self-reported quality of life following a KPT, daily life can nevertheless be challenging due to the risk of organ rejection and side effects from immunosuppressive drugs. Little is known about KPT recipients' personal experiences of the transition from chronic disease to daily life after a KPT. Objective:To examine patients' experiences in the transition from a life with diabetes and chronic renal failure to daily life in the rst year after a KPT. PEER-REVIEWED RESEARCH AuthorsMethod: The study has an exploratory design, and data are collected through semi-structured interviews. Six men agreed to an interview at the one-year follow-up after their KPT, and we used a stepwise deductive-inductive method to analyse the interviews.Results: Transplant recipients' new daily life was characterised by greater autonomy, independence, coping and motivation, but also by new elements of uncertainty. The main uncertainties related to fear of the new organs being rejected and side effects from immunosuppressive drugs. Conclusion:The study provides an insight into the everyday challenges faced by transplant recipients in the rst year after a KPT. One key nding of the study was the need for a greater focus on good information before and after a KPT, both for patients and their families. More tailored patient education and psychosocial support over time can be crucial the rst year after transplantation.

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