作者
Nadine Gronewold,Fabian Schunn,Andreas Ihrig,Gwendolyn Mayer,Sascha Wohnsland,Petra Wagenlechner,Maren Leuschner,Michael M. Kreußer,Claudia Sommerer,Christian Rupp,Hans‐Christoph Friederich,Jobst‐Hendrik Schultz,Bastian Bruns
摘要
ABSTRACT Objective Psychosocial parameters play a pivotal role in organ recipient evaluation before wait-listing for transplantation because of their impact on organ and patient outcome. Patients in need of heart (HTx), liver (LTx), or kidney transplantation (KTx) face distinct physical and psychological challenges. This study compares the psychosocial characteristics and preferences for additional therapy for patients undergoing assessment for these three types of organ transplantation to optimize patient-tailored psychological, social, and other supportive interventions. Methods We conducted a cross-sectional, observational study with 1110 potential transplantation candidates (LTx, n = 544; KTx, n = 330; HTx, n = 236), psychosocial status was determined for depressive symptoms (Patient Health Questionnaire Depression Scale), anxiety symptoms (seven-item Generalized Anxiety Disorder Screener), health-related quality of life (36-Item Short Form Health Survey), perceived social support (Perceived Social Support Questionnaire), sense of coherence (SoC; short form of the Sense of Coherence Scale), self-efficacy (General Self-Efficacy Short Scale), and body image (German Body Image Questionnaire-20). Preferences for additional supportive therapy were assessed dichotomously. Data were analyzed using multivariate analysis of covariance and χ 2 tests. Results Patient groups differed significantly regarding depression ( F (2,1107) = 35.283, p < .001, partial η 2 = 0.01), anxiety ( F (2,1107) = 15.027, p < .001, partial η 2 = 0.03), health-related quality of life (physical: F (2,1107) = 96.772, p < .001, partial η 2 = 0.15; mental: F (2,1107) = 11.442, p < .001, partial η 2 = 0.02), perceived social support ( F (2,1107) = 20.813, p < .001, partial η 2 = 0.04), SoC ( F (2,1107) = 12.920, p < .001, partial η 2 = 0.02), self-efficacy ( F (2,1107) = 17.308, p < .001, partial η 2 = 0.03), and body image (rejecting body evaluation: F (2,1107) = 5.006, p = .007, partial η 2 = 0.01; vital body dynamics: F (2,1107) = 40.216, p < .001, partial η 2 = 0.07). Patients evaluated for HTx showed the highest psychosocial impairment and the highest inclination regarding additional supportive therapy. Conclusions Patients evaluated for HTx, LTx, and KTx have distinct psychosocial characteristics and treatment preferences. HTx patients display the highest psychosocial impairment. We suggest psychocardiological treatment structures for optimal outcome.