Pain and health related quality of life after heart, kidney, and liver transplantation

Forsberg, Anna; Lorenzon, Ulrika; Nilsson, Folke; Bäckmana, Lars

doi:10.1034/j.1399-0012.1999.130603.x

Cited by 56 publications

(51 citation statements)

References 23 publications

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“…Even so, the lack of differences between patients with low and high HADS scores with regard to the transplant-related factors investigated make it improbable that in the population investigated, anxiety and depression are only a reaction to a poor course of treatment. Furthermore, results of previous prospective studies on smaller numbers of patients 4,[12][13][14][15]17,18 likewise support the interpretation that psychosocial parameters are to a large extent independent predictors of the course of treatment.…”

Section: Discussionsupporting

confidence: 65%

“…11 Cross-sectional studies and some prospective studies with a limited number of patients found associations between anxiousness and depression and a poor course of treatment after transplantation. [12][13][14][15][16] Meaningful predictors for survival and other param-eters of posttransplantation outcome were maladaptive coping (such as not making use of appropriate medical, psychosocial, or personal resources), pretransplantation compliance, and presence of social support. 17,18 In heart transplant recipients, Dew et al 4 showed that avoidant coping strategies shown before transplantation increased the risk for developing a mental disorder after transplantation.…”

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confidence: 99%

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The relevance of anxiety, depression, and coping in patients after liver transplantation

Nickel

Wünsch

Egle

et al. 2002

Liver Transplantation

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The aim of this study is to investigate the effects of anxiety, depression, and coping on quality of life in patients after liver transplantation. Patients were asked to fill out a postal survey. Two hundred thirty-six of 375 patients (63%) who entered the study returned the questionnaires, and 186 of these patients could be included in the assessment. Anxiety and depression were surveyed using the Hospital Anxiety and Depression Scale; health-related quality of life, using the 36-Item Short-Form Health Survey; and coping strategies, using the Freiburg Questionnaire on Coping With Illness. In terms of physical and mental dimensions of health-related quality of life, psychosocial factors are far more relevant in liver transplant recipients than purely somatic factors, such as the number of posttransplantation complications or length of hospital stay. Through multiple regression analysis, we were able to account for 51% of the variance in the physical dimension of health-related quality of life and 58% of the variance in the mental dimension. Physical factors of depression, age, and employment and mental factors of anxiety and depression were significant for predicting healthrelated quality of life after liver transplantation. Depressive coping, anxiety, and depression, as well as aspects of the social environment, contribute considerably to determine well-being and health-related quality of life of patients after liver transplantation. O ver the past 15 years, liver transplantation has proven to be the treatment of choice in patients with terminal liver disease. The 1-year survival rate is approximately 80%; after 8 years, 61% of patients are still alive. 1 From the physician's point of view, it is necessary to optimize therapy with immunosuppressants and minimize complications with medical treatment. Diabetes mellitus, malignancies, weight gain, and, particularly, non-Hodgkin's lymphomas have been observed, in addition to increased rates of hypertension. Furthermore, the likelihood of fractures increases after transplantation. 2,3 These associated diseases, along with the transplantation procedure itself and changes in the patient's surroundings, exert considerable influence on a patient's quality of life.Previous investigations into quality of life in transplant recipients focused primarily on the relation between medical treatment and transplantation, i.e., type of immunosuppression, duration and severity of illness, and course of the transplantation (revisions, retransplantation, rejection responses), in addition to effects of these factors on patients' quality of life. 4,5 Posttransplantation health-related quality of life is impaired by disease severity and previous transplantations. 6 A controlled study found no difference in quality of life or psychiatric outcomes between patients who underwent liver transplantation because of alcoholic liver disease and those who underwent liver transplantation because of other chronic liver diseases. 7 Previous results indicated that lung, heart, and liver transplant re...

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Section: Discussionsupporting

confidence: 65%

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confidence: 99%

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The relevance of anxiety, depression, and coping in patients after liver transplantation

Nickel

Wünsch

Egle

et al. 2002

Liver Transplantation

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“…However, fifty-three percent of all patients reported bodily pain to be an important problem after organ transplantation, affecting daily living and it limits physical function, vitality and general health. 52 Factors associated with good health related quality of life Alongside, there are some factors that were found to be associated with improved HRQoL. Among these seems to be heart revascularization especially in CAD elderly patients.…”

Section: Transplanted Patientsmentioning

confidence: 99%

Quality of life in chronic disease patients

2013

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During the past decades there was an increasing predominance of chronic disorders, with a large number of people living with chronic diseases that can adversely affect their quality of life. The aim of the present paper is to study quality of life and especially Healthrelated quality of life (HRQoL) in chronic diseases. HRQOL is a multidimensional construct that consists of at least three broad domains − physical, psychological, and social functioning − that are affected by one's disease and/or treatment. HRQoL is usually measured in chronic conditions and is frequently impaired to a great extent. In addition, factors that are associated with good and poor HRQoL, as well as HRQoL assessment will be discussed. The estimation of the relative impact of chronic diseases on HRQoL is necessary in order to better plan and distribute health care resources aiming at a better HRQoL.[

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“…Of all KTRs, 39% [95% confidence interval (CI) [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] were severely fatigued. This percentage was significantly higher than in the matched control group (22%, 95% CI 16-28, P = 0.001).…”

Section: Prevalence and Impact Of Severe Fatiguementioning

confidence: 99%

Severe fatigue after kidney transplantation: a highly prevalent, disabling and multifactorial symptom

et al. 2013

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SummaryFatigue is a common symptom of patients with chronic kidney disease, but seldom investigated after transplantation. We determined the prevalence, impact and related factors of severe fatigue in kidney transplant recipients (KTRs). Medical records and questionnaires were used to assess kidney function, donor characteristics, fatigue (Checklist Individual Strength), functional impairments (Sickness Impact Profile), work status, body mass index (BMI), pain, depressive symptoms, social support and sleeping problems in 180 participating KTRs. KTRs were compared with sex-and age-matched population-based controls. KTRs were significantly more often severely fatigued (39%) compared to matched controls (22%; P = 0.001). Severely fatigued KTRs had significantly more functional impairments than nonseverely fatigued recipients (effect size ≥ 0.7) P < 0.001, and less often a paid job (27% vs. 48%, P = 0.005). Univariate analysis showed that severely fatigued KTRs received more often a kidney from a deceased donor, had a higher BMI, more pain, discrepancy in social support, depressive symptoms and sleeping problems. In a multivariate analysis (n = 151) the latter two associations remained significant. Severe fatigue is a highly prevalent and disabling symptom in KTRs. Moreover, severe fatigue after kidney transplantation is more strongly related to behavioural and psychosocial factors than specific transplantation-related factors. Findings have implications for fatigue management.

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Pain and health related quality of life after heart, kidney, and liver transplantation

Cited by 56 publications

References 23 publications

The relevance of anxiety, depression, and coping in patients after liver transplantation

The relevance of anxiety, depression, and coping in patients after liver transplantation

Quality of life in chronic disease patients

Severe fatigue after kidney transplantation: a highly prevalent, disabling and multifactorial symptom

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