Symptom experiences in patients after heart transplantation

Stiefel, Penelope; Malehsa, D.; Bara, Christoph; Strueber, M.; Haverich, Axel; Kugler, Christiane

doi:10.1177/1359105312454909

Cited by 26 publications

(35 citation statements)

References 38 publications

(63 reference statements)

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“…A subsequent study undertaken with 216 heart transplant recipients demonstrated the internal consistency of this scale. Internal consistency was high for the symptom occurrence (.947) and symptom distress (.984) subscales [19]. …”

Section: Methodsmentioning

confidence: 99%

Pilot testing a model of psychological care for heart transplant recipients

et al. 2016

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BackgroundAnxiety and depression are common after heart transplantation. This study aimed to pilot test the feasibility of a clinical model of psychological care for heart transplant recipients. The model of care involved nurse-led screening for anxiety and depression followed by referral for a course of telephone-delivered cognitive behaviour therapy as well as co-ordination of communication with on-going specialist and primary care services.MethodsA pilot randomised controlled trial was conducted. Heart transplant recipients who self-reported at least mild anxiety or depressive symptoms were randomised (defined as a score higher than 5 on the Patient Health Questionnaire-9 or the Generalized Anxiety Disorder-7 [GAD-7], or a score higher than 20 on the Kessler Psychological Distress Scale [K10]). The primary outcome was assessment of feasibility of conducting a larger trial, which included identification of recruitment and attrition rates as well as the acceptability of the intervention. Follow-up was conducted at 9 weeks and 6 months.ResultsOne hundred twenty-two of the 126 (97 %) heart transplant recipients assessed on their attendance at the outpatient clinic met the study eligibility criteria. Of these patients, 88 (72 %) agreed to participate. A moderate proportion of participants (n = 20; 23 %) reported at least mild symptoms of anxiety or depression. Five participants were excluded because they were currently receiving psychological counselling, two withdrew before randomisation and the remaining 13 were randomised (seven to intervention and six to usual care). The majority of the randomised participants were male (n = 9; 69 %) and aged over 60 (range 35–73). Median length of time post-transplant was 9.5 years (ranging from 1 to 19 years). On enrolment, 3 randomised participants were taking anti-depressants. One intervention group participant withdrew and a further 3 (50 %) declined the telephone-delivered CBT sessions; all because of restrictions associated with physical illnesses. Attrition was 30 % at the 6 month follow-up time-point.ConclusionsDue to the poor acceptability of telephone-delivered cognitive behavioural therapy observed in our sample, changes to intervention components are indicated and further pilot testing is required.Trial registration ACTRN12613000740796 Date registered: 03/07/2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-016-0183-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Pilot testing a model of psychological care for heart transplant recipients

et al. 2016

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“…In a Canadian study published in 2010 using the SF-36 to assess pain in 92 heart transplant recipients, the results showed that 46% of patients reported at least mild pain and 21% reported moderate to severe pain (14) . Moreover, physical symptoms, such as fatigue, lack of energy, and nervousness, are associated with patients' perceptions after heart transplant and may last more than one year after surgery, which can be a barrier to patients achieving better QOL by affecting their mental, social, and physical well-being (15) . These data are in agreement with the present results, which showed no statistically significant difference in bodily pain or role-physical dimensions between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Comparação da qualidade de vida entre pacientes em lista de espera e pacientes submetidos a transplante cardíaco

Mantovani

Silveira

Lima

et al. 2016

Rev. Gaúcha Enferm.

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Objectives:To compare the quality of life (QOL) between wait-listed patients and heart transplant recipients. Methods:Cross-sectional study of 56 adult patients at two institutions in Southern Brazil, 9(16%) wait-listed patients and 47(84%) transplant recipients. Data were collected from August to December 2012. QOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), with scores ranging from zero to 100. Results:There was statistically significant difference between the two groups in the overall QOL score (p=0.010) and in four dimensions. The mean rank was 16.9 in wait-listed patients and 30.7 in transplant recipients. Wait-listed patients presented the lowest for general health (9.1) and the highest scores for role-emotional (24.8). Transplant recipients obtained the highest scores for general health (32.2) and the lowest scores for bodily pain (29.1). Conclusions:Undergoing a transplant has a positive impact on the QOL of recipients compared to that of patients awaiting transplantation.Keywords: Heart transplantation. Quality of life. Patient care team. RESUMO Objetivos: Comparar a qualidade de vida (QV) entre pacientes em lista de espera e pacientes submetidos a transplante cardíaco. Métodos: Estudo transversal conduzido com 56 pacientes adultos em duas instituições de referência no sul do Brasil, 9(16%) em lista de espera e 47(84%) transplantados. A coleta de dados ocorreu entre agosto e dezembro de 2012. Utilizou-se o Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), com escores variando de zero a 100.Resultados: Houve diferença estatística no escore geral da QV entre os grupos (p=0,010) e em quatro domínios. A média das ordenações (mean rank) foi igual a 16,9 nos pacientes em lista de espera e 30,7 nos pacientes transplantados. Pacientes em lista de espera tiveram o menor escore no estado geral de saúde (9,1) e maior escore nos aspectos emocionais (24,8); pacientes transplantados apresentaram maior pontuação no estado geral de saúde e pior pontuação na dor (29,1). Conclusões:A realização de transplante impacta positivamente na QV dos pacientes, quando comparada à CV daqueles em lista de espera. Palavras-chave: Transplante de coração. Qualidade de vida. Equipe de assistência ao paciente. RESUMEN Objetivo: Comparar la calidad de vida (CV) entre pacientes en lista de espera y pacientes sometidos a trasplante cardíaco. Método: Estudio transversal, realizado con 56 pacientes adultos en las dos instituciones más importantes en el sur de Brasil, 9(16%) en lista de espera y 47(84%) sometidos a trasplante de corazón. Los datos fueron recogidos entre agosto y diciembre de 2012. Se utilizó el Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), con puntuaciones que van de cero a 100.Resultados: Hubo diferencia estadísticamente significativa en la puntuación global de QV entre los grupos (p=0.010) y en cuatro dominios. El promedio de las ordenaciones (mean rank) fue igual a 16,9 en pacientes en lista de espera y 30,7 en pacientes con trasplante. L...

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“…Las complicaciones psicológicas más comunes son los trastornos del estado de ánimo y dentro de éstos, los trastornos depresivos, con una prevalencia que oscila entre el 10 y el 58% 22,24 . La depresión es un problema clínico de gran importancia, ya que puede ser un factor de riesgo para las conductas de no adherencia al tratamiento, lo que provoca a su vez el rechazo del órgano, una disminución de la calidad de vida y un aumento de su morbi-mortalidad en un alto porcentaje de pacientes 21,22,[24][25][26][27][28][29][30] .…”

Section: Las Repercusiones Psicológicasunclassified

“…Por un lado, pierden la seguridad que les proporciona la atención hospitalaria, lo que los lleva a pensar en el riesgo de infección, rechazo y muerte. Y, por otro lado, tras el alta, los familiares suelen distanciarse de ellos debido a que consideran que los pacientes han regresado a una vida normal 21,22,[24][25][26][27][28][29][30] . Así, en un estudio que realizaron Kugler y col 26 observaron que, a los tres años postrasplante, el 9% de los pacientes tenía un nivel de ansiedad grave.…”

Section: Las Repercusiones Psicológicasunclassified

“…El miedo es otro sentimiento que se da casi en el 51% de los pacientes, debido principalmente al riesgo de rechazo y muerte. Las personas se sienten en peligro, sobre todo, cuando un compañero suyo fallece, porque les provoca un sentimiento de inestabilidad intensa 9,11,30 . Un paciente lo denomina el "síndrome de los diez pequeños indios" ya que comentaba: cinco de nosotros fuimos trasplantados sucesivamente, tres ya han fallecido y ahora soy yo el que está en el hospital, es como la historia de los diez pequeños indios... ¿Seré yo el próximo en ir?…”

Section: Las Repercusiones Psicológicasunclassified

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