1
|
Dalvindt M, Veungen HL, Kisch A, Nozohoor S, Lennerling A, Forsberg A. Symptom Distress Before and After Heart Transplantation - A Longitudinal 5-Year Follow-Up. Clin Transplant 2024; 38:e15385. [PMID: 38973775 DOI: 10.1111/ctr.15385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/20/2024] [Accepted: 06/06/2024] [Indexed: 07/09/2024]
Abstract
INTRODUCTION Symptom distress after heart transplantation (HTx) is a significant problem causing uncertainty, low self-efficacy, and psychological distress. Few studies have addressed self-reported symptoms. The aim was to explore self-reported symptom distress from time on the waiting list to 5 years after HTx and its association with self-reported psychological well-being, chronic pain, and fatigue in order to identify possible predictors of psychological or transplant specific well-being. METHODS This multicenter, longitudinal cohort study includes 48 heart recipients (HTRs), 12 women, and 36 men, with a median age of 57 years followed from pretransplant to 5 years post-transplant. Symptom distress was explored by means of four instruments measuring psychological general wellbeing, transplant specific wellbeing, pain, and fatigue. RESULTS Transplant specific well-being for the whole improved in a stepwise manner during the first 5 years compared to pretransplant. Heart transplant recipients with poor psychological wellbeing were significantly more burdened by symptom distress, in particular sleep problems and fatigue, for up to 5 years after HTx, and their transplant-specific well-being never improved compared to baseline. The prevalence of pain varied from 40% to 60% and explained a significant proportion of the variance in transplant-specific well-being, while psychological general well-being was mainly predicted by overall symptom distress. CONCLUSION The presence of distressing symptoms explains a significant proportion of poor psychological wellbeing both among HTRs reporting chronic pain and those without pain.
Collapse
Affiliation(s)
- Marita Dalvindt
- Institute of Health Sciences at Lund University, Lund, Sweden
- Education Unit, Ystad County Hospital, Ystad, Sweden
| | - Hannah Lindahl Veungen
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Annika Kisch
- Institute of Health Sciences at Lund University, Lund, Sweden
- Department of Haematology at Skåne University Hospital, Lund, Sweden
| | - Shahab Nozohoor
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Annette Lennerling
- The Transplant Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Forsberg
- Institute of Health Sciences at Lund University, Lund, Sweden
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
2
|
Chui B, Day R, Umashankar E, Abdel Shaheed C, Keogh A, Girgis L, Penglase R. Meta-analysis and systematic review of gout prevalence in the heart/lung transplantation population. FRONTIERS IN TRANSPLANTATION 2024; 3:1356058. [PMID: 38993785 PMCID: PMC11235269 DOI: 10.3389/frtra.2024.1356058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/15/2024] [Indexed: 07/13/2024]
Abstract
Introduction Gout may complicate solid organ transplantation with potentially serious consequences. An accurate prevalence of gout in this population is unknown. Objectives This study aimed to estimate the prevalence of gout in the heart and/or lung transplantation population through a systematic review and meta-analysis. Methods MEDLINE, Embase, PsycINFO, CENTRAL and Cochrane Library (inception to February 2022) were searched for studies that reported the prevalence and/or incidence of gout in heart and/or lung transplant recipients. Two authors extracted outcomes data. Data were pooled using a random effects model. Overall quality of evidence was assessed using GRADE. Primary outcomes were the prevalence of pre- or post-transplant gout expressed as a prevalence rate (95% CI). Secondary outcomes included risk factors for gout, adverse events, and therapeutic complications of gout treatment. Results Ten studies were included. Gout prevalence (PR) was 8% pre-transplant (PR = 0.08; 95% CI: 0.05-0.12; 4 studies n = 651) and 6% post-transplant (PR = 0.06; 95% CI: 0.06-0.06; 10 studies n = 45,298). Post-transplant gout prevalence in heart transplant recipients was almost three times higher than lung transplant recipients (PR = 0.16; 95% CI: 0.13-0.20 vs. PR = 0.06; 95% CI: 0.05-0.06 respectively). Patients with a pre-transplant history of gout had a higher risk of developing post-transplant gout than patients without (RR = 3.61; 95% CI: 2.19-5.95). Factors associated with gout and outcomes for heart and/or lung transplant recipients with gout were comprehensively reviewed from the included studies. Conclusion Gout is highly prevalent in heart and/or lung transplant patients. Pre-transplant gout is predictive of developing symptomatic post-transplant gout. This has significant implications for management of heart/lung transplant patients. Systematic Review Registration https://www.crd.york.ac.uk/, PROSPERO (CRD42020190632).
Collapse
Affiliation(s)
- Benedict Chui
- Faculty of Medicine and Health, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Richard Day
- Faculty of Medicine and Health, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
- Department of Clinical Pharmacology, St Vincent’s Hospital, Sydney, NSW, Australia
| | - Eshwar Umashankar
- Faculty of Medicine and Health, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Christina Abdel Shaheed
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Anne Keogh
- Faculty of Medicine and Health, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Laila Girgis
- Faculty of Medicine and Health, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
- Department of Rheumatology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Ross Penglase
- Faculty of Medicine and Health, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
- Department of Rheumatology, St Vincent's Hospital, Sydney, NSW, Australia
- St Vincent’s Centre for Applied Medical Research, Sydney, NSW, Australia
| |
Collapse
|
3
|
Mahmoudi R, Moitie T, Dorent R, Guillemin F, Couchoud C. Implementation of patient‐reported outcome measures in a heart transplant recipient registry: first step toward a patient‐centered approach. Clin Transplant 2022; 36:e14708. [DOI: 10.1111/ctr.14708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Redouane Mahmoudi
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| | - Tiphaine Moitie
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| | - Richard Dorent
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
- Département de cardiologie Hôpital Bichat – Claude‐Bernard Assistance Publique Hôpitaux de Paris Paris France
| | | | - Cécile Couchoud
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| |
Collapse
|
4
|
Vejpongsa P, Torre-Amione G, Marcos-Abdala HG, Kumar S, Youker K, Bhimaraj A, Nagueh SF. Long term development of diastolic dysfunction and heart failure with preserved left ventricular ejection fraction in heart transplant recipients. Sci Rep 2022; 12:3834. [PMID: 35264640 PMCID: PMC8907212 DOI: 10.1038/s41598-022-07888-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
Heart transplant recipients (HTX) have several risk factors for heart failure which can trigger pro-inflammatory and fibrosis factors and set into motion pathophysiologic changes leading to diastolic dysfunction and HFpEF. The objective of the study was to determine if HTX recipients with dyspnea have diastolic dysfunction and HFpEF. Twenty-five HTX were included. LV systolic and diastolic functions were evaluated using conductance catheters to obtain pressure volume loops. LV function was assessed at rest and during moderate intensity exercise of the upper extremities. A significant increase occurred in LV minimal pressure (3.7 ± 3.3 to 6.5 ± 3.5 mmHg) and end diastolic pressure or EDP (11.5 ± 4 to 18 ± 3.8 mmHg, both P < 0.01) with exercise. With exercise, the time constant of LV relaxation shortened in 2, was unchanged in 3, and increased in the remaining patients (group results: rest 40 ± 11.6 vs 46 ± 9 ms, P < 0.01). LV chamber stiffness constant was abnormally increased in all but 2 patients. Indices of LV systolic properties were normal at rest but failed to augment with exercise. In 15 who agreed to blood draw, inflammation and fibrosis markers were obtained. A significant association was observed between LV EDP and Pro-Col III N-terminal (r = 0.58, P = 0.024) and IL-1-soluble receptor (r = 0.59, P = 0.02) levels. HTX have diastolic dysfunction and can develop HFpEF several years after cardiac transplantation. The abnormally increased LV chamber stiffness and the prolongation or lack of shortening of the time constant of LV relaxation with exercise are the underlying reasons behind the observed changes in LV diastolic pressures with exercise.
Collapse
Affiliation(s)
- Pimprapa Vejpongsa
- Houston Methodist Hospital, 6550 Fannin, SM-1832, Houston, TX, 77025, USA
| | | | | | - Salil Kumar
- Houston Methodist Hospital, 6550 Fannin, SM-1832, Houston, TX, 77025, USA
| | - Keith Youker
- Houston Methodist Hospital, 6550 Fannin, SM-1832, Houston, TX, 77025, USA
| | - Arvind Bhimaraj
- Houston Methodist Hospital, 6550 Fannin, SM-1832, Houston, TX, 77025, USA.
| | - Sherif F Nagueh
- Houston Methodist Hospital, 6550 Fannin, SM-1832, Houston, TX, 77025, USA.
| |
Collapse
|
5
|
Almgren M, Lundqvist P, Lennerling A, Forsberg A. Fatigue after heart transplantation - a possible barrier to self-efficacy. Scand J Caring Sci 2020; 35:1301-1308. [PMID: 33369757 PMCID: PMC9291191 DOI: 10.1111/scs.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/13/2020] [Accepted: 11/29/2020] [Indexed: 11/20/2022]
Abstract
Rationale Recovery after heart transplantation is challenging and many heart recipients struggle with various transplant‐related symptoms, side‐effects of immunosuppressive medications and mental challenges. Fatigue has been reported to be one of the most common and distressing symptoms after heart transplantation and might therefore constitute a barrier to self‐efficacy, which acts as a moderator of self‐management. Aim To explore the prevalence of fatigue and its relationship to self‐efficacy among heart recipients 1–5 years after transplantation. Research method An explorative cross‐sectional design, including 79 heart recipients due for follow‐up 1–5 years after transplantation. Three different self‐assessment instruments were employed; The Multidimensional Fatigue Inventory‐19, Self‐efficacy for managing chronic disease 6‐Item Scale and The Postoperative Recovery Profile. Ethical approval The study was approved by the Regional Ethics Board of Lund (Dnr. 2014/670‐14/10) with supplementary approval from the Swedish Ethical Review Authority (Dnr. 2019‐02769). Results The reported levels of fatigue for the whole group were moderate in all dimensions of the Multidimensional Fatigue Inventory‐19, with highest ratings in the General Fatigue sub‐scale. Those most fatigued were the groups younger than 50 years; pretransplant treatment with Mechanical Circulatory Support; not recovered or had not returned to work. Self‐efficacy was associated with the sub‐dimensions Mental Fatigue (ρ = −0·.649) and Reduced Motivation (ρ = −0·617), which explained 40·1% of the variance when controlled for age and gender. Study limitations The small sample size constitutes a limitation. Conclusions The moderate levels of fatigue reported indicate that it is not a widespread problem. However, for those suffering from severe fatigue it is a troublesome symptom that affects the recovery process and their ability to return to work. Efforts should be made to identify those troubled by fatigue to enable sufficient self‐management support.
Collapse
Affiliation(s)
- Matilda Almgren
- Department of Health Sciences at Lund University, Lund, Sweden
| | - Pia Lundqvist
- Department of Health Sciences at Lund University, Lund, Sweden
| | - Annette Lennerling
- The Transplant Centre, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Forsberg
- Department of Health Sciences at Lund University, Lund, Sweden.,Department of Thoracic surgery at, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
6
|
Dew MA, DiMartini AF, Dobbels F, Grady KL, Jowsey-Gregoire SG, Kaan A, Kendall K, Young QR, Abbey SE, Butt Z, Crone CC, De Geest S, Doligalski CT, Kugler C, McDonald L, Ohler L, Painter L, Petty MG, Robson D, Schlöglhofer T, Schneekloth TD, Singer JP, Smith PJ, Spaderna H, Teuteberg JJ, Yusen RD, Zimbrean PC. The 2018 ISHLT/APM/AST/ICCAC/STSW Recommendations for the Psychosocial Evaluation of Adult Cardiothoracic Transplant Candidates and Candidates for Long-term Mechanical Circulatory Support. PSYCHOSOMATICS 2018; 59:415-440. [DOI: 10.1016/j.psym.2018.04.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/09/2018] [Indexed: 12/28/2022]
|
7
|
Dew MA, DiMartini AF, Dobbels F, Grady KL, Jowsey-Gregoire SG, Kaan A, Kendall K, Young QR, Abbey SE, Butt Z, Crone CC, De Geest S, Doligalski CT, Kugler C, McDonald L, Ohler L, Painter L, Petty MG, Robson D, Schlöglhofer T, Schneekloth TD, Singer JP, Smith PJ, Spaderna H, Teuteberg JJ, Yusen RD, Zimbrean PC. The 2018 ISHLT/APM/AST/ICCAC/STSW recommendations for the psychosocial evaluation of adult cardiothoracic transplant candidates and candidates for long-term mechanical circulatory support. J Heart Lung Transplant 2018; 37:803-823. [PMID: 29709440 DOI: 10.1016/j.healun.2018.03.005] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 12/11/2022] Open
Abstract
The psychosocial evaluation is well-recognized as an important component of the multifaceted assessment process to determine candidacy for heart transplantation, lung transplantation, and long-term mechanical circulatory support (MCS). However, there is no consensus-based set of recommendations for either the full range of psychosocial domains to be assessed during the evaluation, or the set of processes and procedures to be used to conduct the evaluation, report its findings, and monitor patients' receipt of and response to interventions for any problems identified. This document provides recommendations on both evaluation content and process. It represents a collaborative effort of the International Society for Heart and Lung Transplantation (ISHLT) and the Academy of Psychosomatic Medicine, American Society of Transplantation, International Consortium of Circulatory Assist Clinicians, and Society for Transplant Social Workers. The Nursing, Health Science and Allied Health Council of the ISHLT organized a Writing Committee composed of international experts representing the ISHLT and the collaborating societies. This Committee synthesized expert opinion and conducted a comprehensive literature review to support the psychosocial evaluation content and process recommendations that were developed. The recommendations are intended to dovetail with current ISHLT guidelines and consensus statements for the selection of candidates for cardiothoracic transplantation and MCS implantation. Moreover, the recommendations are designed to promote consistency across programs in the performance of the psychosocial evaluation by proposing a core set of content domains and processes that can be expanded as needed to meet programs' unique needs and goals.
Collapse
Affiliation(s)
- Mary Amanda Dew
- University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania, USA.
| | - Andrea F DiMartini
- University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania, USA
| | | | - Kathleen L Grady
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Annemarie Kaan
- St. Paul's Hospital, Vancouver, British Columbia, Canada
| | | | | | - Susan E Abbey
- University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Zeeshan Butt
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Sabina De Geest
- Katholieke Universiteit Leuven, Leuven, Belgium; University of Basel, Basel, Switzerland
| | | | | | - Laurie McDonald
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Linda Ohler
- George Washington University, Washington, DC, USA
| | - Liz Painter
- Auckland City Hospital, Auckland, New Zealand
| | | | - Desiree Robson
- St. Vincent's Hospital, Sydney, New South Wales, Australia
| | | | | | - Jonathan P Singer
- University of California at San Francisco, San Francisco, California, USA
| | | | | | | | | | | |
Collapse
|
8
|
Harrison JJ, Mansell H, Blydt-Hansen T. Adverse symptoms of immunosuppressants: A survey of Canadian transplant clinicians. Clin Transplant 2017; 31. [PMID: 28239910 DOI: 10.1111/ctr.12940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/27/2022]
Abstract
Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Society of Transplantation members on their perceptions of ASI including frequency, perceived QOL impact, causal attribution, management strategies, and success. Sixty-one clinicians participated in the survey of 12 ASI (tremor, diarrhea, nausea, constipation, dyspepsia, insomnia, edema, dyspnea, arthralgia, acne, mouth sores, paresthesias), for a 22% response rate. Forty-nine completed the survey (80% completion rate). Diarrhea, dyspepsia, and insomnia were most frequent, requiring management in ≥ 2% of patients by 96%, 90%, and 82% of respondents, respectively. Diarrhea, insomnia, and dyspnea were deemed to have an important QOL impact by 92%, 82%, and 69%. Immunosuppressants were universally implicated as causative of tremor, diarrhea, acne, and mouth sores. Over 80% reported success in managing mouth sores, dyspepsia, and constipation. Management strategies included adjustment of immunosuppressant or other medications, drug therapy, and nonpharmacologic approaches and varied according to perceived causal attribution. More study is needed to compare clinician and patient views. These results will be used to establish priorities for further investigation of ASI.
Collapse
Affiliation(s)
- Jennifer J Harrison
- Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.,Department of Pharmacy Services, Toronto General Hospital, University Health Network, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.,Saskatchewan Transplant Program, Saskatoon, SK, Canada
| | - Tom Blydt-Hansen
- Multi-Organ Transplant Program, BC Children's Hospital, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
9
|
Almgren M, Lennerling A, Lundmark M, Forsberg A. The meaning of being in uncertainty after heart transplantation - an unrevealed source to distress. Eur J Cardiovasc Nurs 2016; 16:167-174. [PMID: 27146379 DOI: 10.1177/1474515116648240] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND As many as 88% of heart transplant recipients (HTRs) suffer from psychological distress. Both psychosocial factors and physical health are associated with increased psychological distress. However, the causes and impacts of psychological distress are unclear. HTRs strive for a sense of control over their health and daily lives in order to improve their psychological well-being. Perceived control was found to be related to the patients' construction of normality, their emotional state, as well as their thoughts and feelings of uncertainty about the future. AIM An in-depth exploration of the meaning of uncertainty during the first year after a heart transplantation (HTX). METHOD A phenomenological-hermeneutic method was employed. Interviews were conducted with 14 patients, four women and ten men, with a mean age of 51 years (range: 28-67 years). RESULTS Being in uncertainty after HTX means losing a sense of coherence, which shatters the HTR's whole worldview. The HTRs search for meaning and strive for coherence, which is no longer achievable. By using a nursing theory, we understand that uncertainty should be seen as a natural state among HTRs. It constitutes the starting point from which the HTRs can reorganise their self-structure and find a new view of life. When striving for normality, certainty and predictability (i.e., the healthcare professional's perspective), we block or prolong this process, thus causing distress among HTRs because they are unable to create a new orientation in life. CONCLUSION This study presents a hypothesis of the primary cause of psychological distress after HTX and provides a useful framework for how to approach this condition.
Collapse
Affiliation(s)
- Matilda Almgren
- 1 Skåne University Hospital, Thoracic Intensive Care Unit, Lund, Sweden.,2 Department of Health Sciences at Lund University, Lund, Sweden
| | - Annette Lennerling
- 3 The Transplant Centre Sahlgrenska University Hospital, Gothenburg, Sweden.,4 The Institute of Health and Caring Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Martina Lundmark
- 1 Skåne University Hospital, Thoracic Intensive Care Unit, Lund, Sweden.,2 Department of Health Sciences at Lund University, Lund, Sweden
| | - Anna Forsberg
- 2 Department of Health Sciences at Lund University, Lund, Sweden.,5 Skåne University Hospital, Department of Transplantation and Cardiology, Lund, Sweden
| |
Collapse
|
10
|
Grady KL, Andrei AC, Li Z, Rybarczyk B, White-Williams C, Gordon R, McGee EC. Gender differences in appraisal of stress and coping 5 years after heart transplantation. Heart Lung 2016; 45:41-7. [PMID: 26514074 PMCID: PMC4691446 DOI: 10.1016/j.hrtlng.2015.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES We examined whether gender differences exist regarding stress, symptom distress, coping, adherence, and social support 5 years after heart transplantation. BACKGROUND Differences exist in health-related quality of life outcomes by gender after heart transplantation; women report poorer outcomes. METHODS Patients (n = 210, female = 42), were from a prospective, multi-site, study of health-related quality of life long-term after heart transplantation. Patients completed self-report instruments 5 years after heart transplantation (mean = 4.98 ± 0.17 years after transplant). Statistical analyses included two-sample t-tests, Chi-square or Fisher's exact test, and multivariable modeling. RESULTS Women did not report more overall stress or symptom distress, but reported more difficulty adhering to the transplant regimen, yet more actual adherence than men. Women reported using more negative coping styles, but reported more satisfaction with social support. CONCLUSIONS Gender differences exist regarding appraisal of stress, coping styles, and coping resources long-term after heart transplantation. These differences may guide tailoring therapy regarding stress, poor coping, and lack of resources.
Collapse
Affiliation(s)
- Kathleen L Grady
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA.
| | - Adin-Cristian Andrei
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA
| | - Zhi Li
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA
| | - Bruce Rybarczyk
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Robert Gordon
- Department of Medicine, Division of Cardiology, Northwestern University, Chicago, IL, USA
| | - Edwin C McGee
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA
| |
Collapse
|
11
|
Delgado J, Almenar L, González-Vilchez F, Arizón J, Gómez M, Fuente L, Brossa V, Fernández J, Díaz B, Pascual D, Lage E, Sanz M, Manito N, Crespo-Leiro M. Health-related quality of life, social support, and caregiver burden between six and 120 months after heart transplantation: a Spanish multicenter cross-sectional study. Clin Transplant 2015; 29:771-80. [DOI: 10.1111/ctr.12578] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/29/2022]
Affiliation(s)
- J.F. Delgado
- Hospital Universitario 12 de Octubre; Madrid Spain
| | - L. Almenar
- Hospital Universitario La Fe; Valencia Spain
| | | | - J.M. Arizón
- Hospital Universitario Reina Sofía; Córdoba Spain
| | - M. Gómez
- Hospital Universitario Puerta de Hierro; Madrid Spain
| | - L. Fuente
- Hospital Clínico Universitario de Valladolid; Valladolid Spain
| | - V. Brossa
- Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - J. Fernández
- Hospital Universitario Gregorio Marañón; Madrid Spain
| | - B. Díaz
- Hospital Universitario Central de Asturias; Oviedo Spain
| | - D. Pascual
- Hospital Universitario Virgen de la Arrixaca; Murcia Spain
| | - E. Lage
- Hospital Universitario Virgen del Rocío; Seville Spain
| | - M. Sanz
- Hospital Universitario Miguel Servet; Zaragoza Spain
| | - N. Manito
- Hospital Universitario de Bellvitge; Barcelona Spain
| | | |
Collapse
|
12
|
Lebensqualität im Langzeitverlauf nach Herztransplantation. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2011. [DOI: 10.1007/s00398-011-0833-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
13
|
Chen HL, Wei J, Huang HC, Lin CW. Mediating effect of symptom severity on the relationship between self-efficacy for exercise and depression. J Clin Nurs 2010; 20:294-6. [DOI: 10.1111/j.1365-2702.2010.03488.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
van der Kloot WA, Hamdy NAT, Hafkemeijer LCS, den Dulk FMC, Chotkan SA, van Emmerik AAP, Kaptein AA. The psychological burden of an initially unexplained illness: patients with sternocostoclavicular hyperostosis before and after delayed diagnosis. Health Qual Life Outcomes 2010; 8:97. [PMID: 20828391 PMCID: PMC2954978 DOI: 10.1186/1477-7525-8-97] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 09/09/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sternocostoclavicular hyperostosis (SCCH) is a rare, debilitating, chronic inflammatory disorder of the anterior chest wall due to a chronic sterile osteomyelitis of unknown origin. SCCH is largely underdiagnosed and often misdiagnosed. In individual cases it can remain unrecognized for years. The purpose of this study is twofold. Firstly, to evaluate the psychological condition of SCCH patients, both in the sometimes quite extended pre-diagnostic period between first manifestations and confirmed diagnosis of the disease, and in the current situation. Secondly, to investigate the relationships between the pre-diagnostic and the current psychological conditions of confirmed SCCH patients. METHODS Structured interviews were held with 52 confirmed SCCH patients. Questionnaires were included to assess posttraumatic stress symptoms, social support, aspects of pain, illness perceptions, self-reported health status, and quality of life. RESULTS SCCH patients reported stronger posttraumatic stress symptoms, more unfavorable illness perceptions, lower health status, and poorer quality of life than healthy individuals and patients with other diseases or traumatic experiences. Psychological distress in the pre-diagnostic period was associated with unfavorable conditions in the current situation. CONCLUSION SCCH is an illness with serious psychological consequences. Psychological monitoring of patients with unexplained complaints is recommended as long as a diagnosis has not been reached.
Collapse
Affiliation(s)
| | - Neveen AT Hamdy
- Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center (LUMC), The Netherlands
| | | | | | - Sadhna A Chotkan
- Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center (LUMC), The Netherlands
| | | | - Ad A Kaptein
- Unit of Psychology, Leiden University Medical Center (LUMC), The Netherlands
| |
Collapse
|
15
|
Jalowiec A, Grady KL, White-Williams C. Gender and age differences in symptom distress and functional disability one year after heart transplant surgery. Heart Lung 2010; 40:21-30. [PMID: 20561875 DOI: 10.1016/j.hrtlng.2010.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Revised: 02/01/2010] [Accepted: 02/09/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Symptoms and functional status are major concerns for heart transplant (HT) recipients. The study objective was to examine gender and age differences in symptom distress and functional disability 1 year after HT surgery. METHODS The sample (N = 237) consisted of 44 female and 193 male patients who were divided into younger (n = 66) and older (n = 171) groups with the breakpoint at age 50 years. Data from chart review and 2 questionnaires (Heart Transplant Symptom Checklist and Sickness Impact Profile) were analyzed with chi-square test, t tests, analysis of variance, and multivariate analysis of variance. RESULTS Women reported worse symptom distress (overall, plus cardiovascular, gastrointestinal, dermatologic symptoms) and more functional disability (overall, plus disability in ambulation, mobility, self-care, home management). Older patients reported more disability in ambulation and work. Gender by age interactions showed that older men reported worse genitourinary symptoms and younger women reported worse dermatologic symptoms. CONCLUSION There were more gender than age differences in symptoms and disability.
Collapse
Affiliation(s)
- Anne Jalowiec
- School of Nursing, Loyola University, Chicago, Illinois, USA.
| | | | | |
Collapse
|