Psychological Stress in Transplantation: A Unified Concept? What is Measured and How: A Literature Review

Abstract

This article describes how the concept of stress is studied in the field of solid-organ transplantation. Sixty-five articles or reviews of scientific research on stress are analyzed. The question addressed was how stress is explored and defined in transplant research, as it is often referred to as affecting psychological and/or physical transplant outcomes.

Emotions while awaiting lung transplantation: A comprehensive qualitative analysis

“…The lack of clear evaluation or differentiation between anxiety and depression or stress in transplantation (Rapo and Piot-Ziegler, 2013) and in other illness contexts is also extensively discussed (Bowman, 2001; Szabò, 2011). …”

“…In transplantation, most of the research focuses on negative emotions, to prevent ‘mental morbidity’ or in using depression as a predictor of psychological fragility (Dobbels et al, 2006). The lack of clear evaluation or differentiation between anxiety and depression or stress in transplantation (Rapo and Piot-Ziegler, 2013) and in other illness contexts is also extensively discussed (Bowman, 2001; Szabò, 2011).…”

Appraisal of transplant‐related stressors, coping strategies, and psychosocial adjustment following kidney transplantation

“…The main effects model proposes that stress appraisal and coping strategies have direct and independent effects on adjustment (Lazarus & Folkman, ; Folkman & Moskowitz, ). Several studies investigated the role of stress appraisal on post‐transplant adjustment (Rapo & Piot‐Ziegler, ). Burker, Evon, Sedway, and Egan () enrolled 160 participants with end‐stage lung disease awaiting lung transplantation and applied an adaptation of the Stress Threat Questionnaire (Folkman & Lazarus, ) measuring the four dimensions of stress appraisal: threat, challenge, harm, and benefit.…”

“…Although the number of studies conducted in the context of organ transplantation is growing, recent reviews (Rapo & Piot‐Ziegler, ) concluded that more thorough research on associations and interrelations between stress appraisal, coping strategies, and adjustment dimensions is needed. Research conducted in the context of stressful medical procedures (Knoll, Rieckmann, & Schwarzer, ; Luszczynska, Mohamed, & Schwarzer, ; Park, Sacco, & Edmondson, ; Roubinov, Turner, & Williams, ) indicated direct effects of coping strategies on indexes of adjustment.…”

“…Hence, the psychosocial adjustment following KT has become a relevant issue in the transplantation literature (Achille et al, ; Achille, Ouellette, Fournier, Vachon, & Hebert, ; Arapaslan, Soykan, Soykan, & Kumbasar, ; Engle, ; Waterman et al, ; Ziegelmann et al, ). The transplantation procedures constitute processes which have a profound impact on psychosocial adjustment (Rapo & Piot‐Ziegler, ). High levels of depression and anxiety were consistently found among kidney transplant recipients.…”