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Educational Animations to Inform Transplant Candidates About Deceased Donor Kidney Options: An Efficacy Randomized Trial. Transplant Direct 2020; 6:e575. [PMID: 32766430 PMCID: PMC7339360 DOI: 10.1097/txd.0000000000001026] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/18/2020] [Indexed: 11/01/2022] Open
Abstract
Background Transplant candidates struggle making decisions about accepting kidneys with variable kidney donor profile index (KDPI) and increased risk donor (IRD) status. Methods This single site, pilot randomized controlled trial evaluated the efficacy of 2 animations to improve KDPI/IRD knowledge, decisional self-efficacy, and willingness. Kidney candidates were randomly assigned to animation viewing plus standard nurse discussion (intervention) or standard nurse discussion alone (control). Linear regression was used to test the significance of animation exposure after controlling for covariates (α < 0.1). Results Mean age was 60 years, and 27% were African American. Both intervention (n = 42) and control (n = 38) groups received similar education at similar duration (12.8 versus 11.8 min, respectively), usually by the same dedicated nurse educator (85% versus 75%, respectively). On multivariate analysis, the intervention group (versus control) exhibited significantly increased knowledge (β = 0.23; 95% confidence interval, 0.66-1.77) and IRD willingness (β = 0.22; 95% confidence interval, 0.05-0.86). There were no between-group differences in KDPI >85% willingness or distribution of KDPI/IRD decisional self-efficacy. Over 90% of participants provided positive ratings on each of 11 acceptability items. Conclusions Supporting conventional IRD and KDPI education with educational animations can improve knowledge and IRD willingness compared with standard methods.
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2
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Nolley E, Fleck J, Kavalieratos D, Dew MA, Dilling D, Colman R, Crespo MM, Goldberg H, Hays S, Hachem R, Lease E, Lee J, Reynolds J, Morrell M, Schenker Y. Lung Transplant Pulmonologists' Views of Specialty Palliative Care for Lung Transplant Recipients. J Palliat Med 2020; 23:619-626. [PMID: 31895634 PMCID: PMC7232634 DOI: 10.1089/jpm.2019.0222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Lung transplant recipients with serious illness may benefit from but rarely receive specialty palliative care (SPC) services. Transplant pulmonologists' views of SPC may be key to understanding SPC utilization but have not been well characterized. Objectives: (1) To understand how transplant pulmonologists view SPC and decide to refer transplant recipients and (2) to identify unique aspects of lung transplantation that may influence referral decisions. Design: We conducted semistructured interviews with transplant pulmonologists at nine geographically diverse high-volume North American transplant centers with SPC services. A multidisciplinary team analyzed interview transcripts using constant comparative methods to inductively develop and refine a coding framework related to SPC views and referral decisions. Results: We interviewed 38 transplant pulmonologists; most (36/38) had referred lung transplant recipients to SPC. Participants described SPC as a medical specialty that aims to improve quality of life and distinguished SPC from hospice care, which was considered end-of-life care. Participants who viewed transplant as a temporary solution (n = 17/38, 45%) described earlier utilization of SPC alongside disease-directed therapies, whereas those who viewed transplant as survival-focused (n = 21/38, 55%) described utilization of SPC after disease-directed therapies were exhausted. Concerns about one-year survival metrics and use of addicting medications for symptom palliation were barriers to referral. Conclusions: Transplant pulmonologists' SPC referral practices may be related to their views of lung transplantation. Optimizing use of SPC in lung transplantation will require improving communication between transplant pulmonology and SPC to ensure a collaborative effort toward patient-centered goals while addressing unique barriers to SPC referral.
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Affiliation(s)
- Eric Nolley
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica Fleck
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dio Kavalieratos
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Amanda Dew
- Departments of Psychiatry, Psychology, Epidemiology, Biostatistics, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel Dilling
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Loyola, Chicago, Illinois, USA
| | - Rebecca Colman
- Division of Respirology and Division of Palliative Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maria M. Crespo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hiliary Goldberg
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Steven Hays
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Ramsey Hachem
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University in St Louis, St. Louis, Missouri, USA
| | - Erika Lease
- Department of Medicine, Division of Pulmonary Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - James Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John Reynolds
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Matthew Morrell
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yael Schenker
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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3
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Pawlow PC, Doherty CL, Blumenthal NP, Matura LA, Christie JD, Ersek M. An Integrative Review of the Role of Palliative Care in Lung Transplantation. Prog Transplant 2020; 30:147-154. [DOI: 10.1177/1526924820913512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and the role it plays in their care. Aim: The aim of this integrative review was to synthesize the literature describing the palliative care needs, the current role, and factors influencing the integration of palliative care in the care of lung transplant patients. Design/Data Sources: We searched PubMed, Scopus, CINAHL, and Embase to identify English-language, primary studies focused on palliative care in adult lung transplantation. Study quality was evaluated using Strengthening the Report of Observational studies in Epidemiology and Consolidated Criteria for Reporting Qualitative Research criteria. Results: Seven articles were included in the review. Most were single-center, descriptive studies. Two studies used qualitative and 5 used quantitative methodologies. Collectively, these studies suggest that palliative care is typically consulted for physical and psychological symptom management, although consultation is uncommon and often occurs late in the lung transplant process. We found no studies that systematically assessed palliative needs. Misperceptions about palliative care, communication challenges, and unrealistic patient/family expectations are identified barriers to the integration. While limited, evidence suggests that palliative care can be successfully integrated into lung transplant patient management. Conclusions: Empirical literature about palliative care in lung transplantation is sparse. Further research is needed to define the needs and opportunities for integration into the care of these patients.
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Affiliation(s)
| | | | | | - Lea Ann Matura
- University of Pennsylvania School of Nursing Philadelphia, PA, USA
| | - Jason D. Christie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary Ersek
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Veterans Affairs, Corporal Michael J. Crescenz VA Medical Center, PA, USA
- School of Nursing, Perelman School of Medicine, University of Pennsylvania, PA, USA
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4
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Singer JP, Soong A, Chen J, Shrestha P, Zhuo H, Gao Y, Greenland JR, Hays SR, Kukreja J, Golden J, Gregorich SE, Stewart AL. Development and Preliminary Validation of the Lung Transplant Quality of Life (LT-QOL) Survey. Am J Respir Crit Care Med 2020; 199:1008-1019. [PMID: 30303408 DOI: 10.1164/rccm.201806-1198oc] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RATIONALE Although lung transplantation aims to improve health-related quality of life (HRQL), existing instruments fail to include health domains considered important in this population. OBJECTIVES We aimed to develop a comprehensive lung transplant-specific instrument to address this shortcoming. METHODS We developed a pool of 126 candidate items addressing domains previously identified as important by lung transplant recipients. Through cognitive interviews conducted in 43 transplant recipients, items deemed irrelevant or redundant were dropped. The 84 remaining items were field tested in lung transplant recipients. Exploratory and confirmatory factor analyses were used to evaluate the factor structure, and scales were evaluated for internal consistency and construct validity. MEASUREMENTS AND MAIN RESULTS The 84-item preliminary survey was administered to 201 lung transplant recipients with a mean age of 57.9 (±12.7) years; 46% were female. After factor analyses and internal consistency evaluation, we retained 60 items comprising the Lung Transplant Quality of Life (LT-QOL) Survey. The LT-QOL contains 10 scales that measure symptoms, health perceptions, functioning, and well-being. The confirmatory factor analysis model had good approximate fit (comparative fit index = 0.990; standardized root-mean-square residual = 0.062). Cronbach αs for the 10 scales ranged from 0.75 to 0.95. Interscale correlations were consistent with hypothesized relationships. Subjects with severe chronic lung allograft dysfunction (n = 13) reported significantly worse HRQL than subjects without chronic lung allograft dysfunction (n = 168) on 6 of the 10 LT-QOL scales. CONCLUSIONS The LT-QOL is a new, multidimensional instrument that characterizes and quantifies HRQL in lung transplant recipients.
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Affiliation(s)
- Jonathan P Singer
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - Allison Soong
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - Joan Chen
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - Pavan Shrestha
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - Hanjing Zhuo
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - Ying Gao
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - John R Greenland
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | - Steven R Hays
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | | | - Jeffrey Golden
- 1 Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine
| | | | - Anita L Stewart
- 4 Institute for Health & Aging, University of California, San Francisco, San Francisco, California
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5
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Nolley EP, DeSensi R, Nouraie M, Schenker Y, Morrell MR. Characteristics, Trends, and Predictors of Specialty Palliative Care Utilization after Lung Transplantation. J Palliat Med 2019; 22:1092-1098. [PMID: 30964390 DOI: 10.1089/jpm.2018.0560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Lung transplant recipients who experience serious illness could benefit from specialty palliative care (SPC), but evidence suggests that referral has been rare. Objective: Examine the characteristics of post-transplant SPC encounters, utilization trends, and patient characteristics associated with SPC at a center with established SPC services. Design: Retrospective cohort study of SPC utilization by 597 lung transplant recipients transplanted between 2010 and 2015. We collected data on pretransplant demographics and post-transplant SPC encounters, including timing, location, and referral reasons. Cumulative incidence of SPC and patient characteristics associated with SPC were examined by competing risks methods. Utilization in the first two post-transplant years was compared between subcohorts defined by year of transplantation. Results: SPC cumulative incidence was 27% and 43% at one and five years. More than 60% of encounters occurred in the first post-transplant year including 34% during the index transplant hospitalization. Over 90% of encounters occurred in the inpatient setting. The majority of consults were for symptom management. From 2010 to 2015 inpatient utilization in the first two post-transplant years increased from 23% to 42%, and outpatient utilization increased from 2% to 16%. Accounting for increasing utilization, pretransplant SPC and double-lung transplantation were associated with greater incidence of post-transplant SPC. Conclusions: Lung transplant recipients may have palliative care needs early after transplantation. Increasing utilization suggests greater awareness of or changing attitudes about the utility of SPC for lung transplant recipients. Understanding transplant recipients' palliative care needs and transplant physicians' views of SPC is critical to improving the provision of SPC in lung transplantation.
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Affiliation(s)
- Eric P Nolley
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca DeSensi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mehdi Nouraie
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yael Schenker
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Matthew R Morrell
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Abstract
It is currently estimated that 5.7 million Americans live with heart failure. Of these, less than 3000 will receive a heart transplant this year, according to the US Department of Health and Human Services Organ Procurement and Transplantation Network. With successful transplantation can come significant emotional and physical symptoms that are not always addressed. Although palliative care is an interdisciplinary subspecialty designed to alleviate multiple domains of suffering in serious illness, many mistakenly associate it solely with the end of life. Traditionally associated with cancer, research into the role of palliative care in other chronic illnesses and complex life-changing therapies such as solid organ transplantation remains scarce but is nonetheless developing. Here, we try to investigate a potential role for palliative care for heart transplant recipients. Early research thus far has demonstrated importance of early involvement of palliative care teams and the significant improvement of physical and emotional symptoms in the pre- and post-transplant period. Nevertheless, more research is warranted to determine the ideal timing of palliative care integration, the effects on health care resource utilization, and whether improving quality of life can affect morbidity and mortality. By understanding these critical elements and others we may be able to develop a model for the role of palliative care for heart transplant patients.
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7
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Wentlandt K, Weiss A, O'Connor E, Kaya E. Palliative and end of life care in solid organ transplantation. Am J Transplant 2017; 17:3008-3019. [PMID: 28976070 DOI: 10.1111/ajt.14522] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 09/17/2017] [Accepted: 09/22/2017] [Indexed: 01/25/2023]
Abstract
Palliative care is an interprofessional approach that focuses on quality of life of patients who are facing life-threatening illness. Palliative care is consistently associated with improvements in advance care planning, patient and caregiver satisfaction, quality of life, symptom burden, and lower healthcare utilization. Most transplant patients have advanced chronic disease, significant symptom burden, and mortality awaiting transplant. Transplantation introduces new risks including perioperative death, organ rejection, infection, renal insufficiency, and malignancy. Numerous publications over the last decade identify that palliative care is well-suited to support these patients and their caregivers, yet access to palliative care and research within this population are lacking. This review describes palliative care and summarizes existing research supporting palliative intervention in advanced organ failure and transplant populations. A proposed model to provide palliative care in parallel with disease-directed therapy in a transplant program has the potential to improve symptom burden, quality of life, and healthcare utilization. Further studies are needed to elucidate specific benefits of palliative care for this population. In addition, there is a tremendous need for education, specifically for clinicians, patients, and families, to improve understanding of palliative care and its benefits for patients with advanced disease.
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Affiliation(s)
- K Wentlandt
- Division of Palliative Care, Department of Supportive Care, University Health Network, Toronto, ON, Canada.,Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - A Weiss
- Division of Palliative Care, Department of Supportive Care, University Health Network, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - E O'Connor
- Division of Palliative Care, Department of Supportive Care, University Health Network, Toronto, ON, Canada.,Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - E Kaya
- Division of Palliative Care, Department of Supportive Care, University Health Network, Toronto, ON, Canada.,Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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8
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Singer JP, Katz PP, Soong A, Shrestha P, Huang D, Ho J, Mindo M, Greenland JR, Hays SR, Golden J, Kukreja J, Kleinhenz ME, Shah RJ, Blanc PD. Effect of Lung Transplantation on Health-Related Quality of Life in the Era of the Lung Allocation Score: A U.S. Prospective Cohort Study. Am J Transplant 2017; 17:1334-1345. [PMID: 27743488 PMCID: PMC6085872 DOI: 10.1111/ajt.14081] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/13/2016] [Accepted: 10/04/2016] [Indexed: 01/25/2023]
Abstract
Under the U.S. Lung Allocation Score (LAS) system, older and sicker patients are prioritized for lung transplantation (LT). The impact of these changes on health-related quality of life (HRQL) after transplant has not been determined. In a single-center prospective cohort study from 2010 to 2016, we assessed HRQL before and repeatedly after LT for up to 3 years using the SF12-Physical and Mental Health, the respiratory-specific Airway Questionnaire 20-Revised, and the Euroqol 5D/Visual Analog Scale utility measures by multivariate linear mixed models jointly modeled with death. We also tested changes in LT-Valued Life Activities disability, BMI, allograft function, and 6-min walk test exercise capacity as predictors of HRQL change. Among 211 initial participants (92% of those eligible), LT improved HRQL by all 5 measures (p < 0.05) and all but SF12-Mental Health improved by threefold or greater than the minimally clinically important difference. Compared to younger participants, those aged ≥65 improved less in SF12-Physical and Mental Health (p < 0.01). Improvements in disability accounted for much of the HRQL improvement. In the LAS era, LT affords meaningful and durable HRQL improvements, mediated by amelioration of disability. Identifying factors limiting HRQL improvement in selected subgroups, especially those aged ≥65, are needed to maximize the net benefits of LT.
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Affiliation(s)
- J P Singer
- Department of Medicine, University of California, San Francisco, CA
| | - P P Katz
- Department of Medicine, University of California, San Francisco, CA
| | - A Soong
- Department of Medicine, University of California, San Francisco, CA
| | - P Shrestha
- Department of Medicine, University of California, San Francisco, CA
| | - D Huang
- Department of Medicine, University of California, San Francisco, CA
| | - J Ho
- Department of Medicine, University of California, San Francisco, CA
| | - M Mindo
- Department of Medicine, University of California, San Francisco, CA
| | - J R Greenland
- Department of Medicine, University of California, San Francisco, CA
| | - S R Hays
- Department of Medicine, University of California, San Francisco, CA
| | - J Golden
- Department of Medicine, University of California, San Francisco, CA
| | - J Kukreja
- Department of Surgery, University of California, San Francisco, CA
| | - M E Kleinhenz
- Department of Medicine, University of California, San Francisco, CA
| | - R J Shah
- Department of Medicine, University of California, San Francisco, CA
| | - P D Blanc
- Department of Medicine, University of California, San Francisco, CA
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9
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Song MK, DeVito Dabbs A, Ward SE. A SMART design to optimize treatment strategies for patient and family caregiver outcomes. Nurs Outlook 2016; 64:299-305. [DOI: 10.1016/j.outlook.2016.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/18/2016] [Accepted: 04/30/2016] [Indexed: 11/27/2022]
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10
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Colman R, Singer LG, Barua R, Downar J. Characteristics, Interventions, and Outcomes of Lung Transplant Recipients Co-Managed with Palliative Care. J Palliat Med 2015; 18:266-9. [DOI: 10.1089/jpm.2014.0167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Rebecca Colman
- Division of Respirology, University of Toronto, Toronto, Ontario, Canada
| | - Lianne G. Singer
- Division of Respirology, University of Toronto, Toronto, Ontario, Canada
- Toronto Lung Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - Reeta Barua
- Faculty of Medicine, Queens University, Kingston, Ontario, Canada
| | - James Downar
- Division of Respirology, University of Toronto, Toronto, Ontario, Canada
- Division of Palliative Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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11
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Zanjani F, Downer BG, Hosier AF, Watkins JD. Memory banking: a life story intervention for aging preparation and mental health promotion. J Aging Health 2014; 27:355-76. [PMID: 25239929 DOI: 10.1177/0898264314551170] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The aim of this study is to examine the feasibility of Memory Banking (MB), a life story development intervention within the context of aging preparation. Individuals participate in MB to strategically document and share their life story, including mapping out future dreams, aspirations, plans, and decisions. METHOD Data (2010-2012) from eight MB workshops were examined to determine the impact of the intervention on mental health, social support, and quality of life. RESULTS Recruitment efforts resulted in n = 72 participants, primarily female (72%), White/Caucasian (93%), average age of 70 years. Data indicated intervention effects showing improvements in depression (p = .041), mood disturbance (p = .0067), and cognitive performance (p = .0045). DISCUSSION MB outcomes indicate that the intervention is promising and supports continued investigation and development in the area of life story development for aging preparation and improving late life mental health distress in a community setting. Future research is needed to examine the versatility and long-term effects of the MB intervention.
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12
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Davis LA, Ryszkiewicz E, Schenk E, Peipert J, LaSee C, Miller C, Richardson G, Ridolfi G, Trulock EP, Patterson GA, Waterman A. Lung Transplant or Bust: Patients' Recommendations for Ideal Lung Transplant Education. Prog Transplant 2014; 24:132-41. [DOI: 10.7182/pit2014432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Context Effective lung transplant education helps ensure informed decision making by patients and better transplant outcomes. Objective To understand the educational needs and experiences of lung transplant patients. Design Mixed-method study employing focus groups and patient surveys. Setting Barnes-Jewish Hospital in St Louis, Missouri. Patients 50 adult lung transplant patients: 23 pretransplant and 27 posttransplant. Main Outcome Measures Patients' interest in receiving specific transplant information, the stage in the transplant process during which they wanted to receive the education, and the preferred format for presenting the information. Results Patients most wanted information about how to sustain their transplant (72%), when to contact their coordinator immediately (56%), transplant benefits (56%), immunosuppressants (54%), and possible out-of-pocket expenses (52%). Patients also wanted comprehensive information early in the transplant process and a review of a subset of topics immediately before transplant (time between getting the call that a potential donor has been found and getting the transplant). Patients reported that they would use Internet resources (74%) and converse with transplant professionals (68%) and recipients (62%) most often. Discussion Lung transplant patients are focused on learning how to get a transplant and ensuring its success afterwards. A comprehensive overview of the evaluation, surgery, and recovery process at evaluation onset with a review of content about medications, pain management, and transplant recovery repeated immediately before surgery is ideal.
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Affiliation(s)
- LaShara A. Davis
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Eric Ryszkiewicz
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Emily Schenk
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - John Peipert
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Claire LaSee
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Carol Miller
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Greg Richardson
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Gene Ridolfi
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Elbert P. Trulock
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - G. Alexander Patterson
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
| | - Amy Waterman
- Saint Barnabas Medical Center, Livingston, New Jersey (LAD), Palo Alto Medical Foundation, Sutter Health, Sunnyvale, California (ER), Washington University School of Medicine, St. Louis, Missouri (ES, CL), David Geffen School of Medicine, University of California, Los Angeles (JP, AW), Barnes-Jewish Hospital, St. Louis, Missouri (CM, GR, GR, EPT, GAP)
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13
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Ivarsson B, Ekmehag B, Sjöberg T. Relative's experiences before and after a heart or lung transplantation. Heart Lung 2014; 43:198-203. [DOI: 10.1016/j.hrtlng.2014.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 02/16/2014] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
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Rosenberger EM, Dew MA, DiMartini AF, DeVito Dabbs AJ, Yusen RD. Psychosocial issues facing lung transplant candidates, recipients and family caregivers. Thorac Surg Clin 2013; 22:517-29. [PMID: 23084615 DOI: 10.1016/j.thorsurg.2012.08.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although lung transplantation is an accepted treatment for many individuals with severe lung disease, transplant candidates and recipients experience a range of psychosocial stressors that begin at the initiation of the transplant evaluation and continue throughout patients' wait for donor lungs, their perioperative recovery, and their long-term adjustment to posttransplant life. Transplant programs should strive to incorporate evidence-based interventions that aim to improve physical functioning, psychological distress, global quality of life, and medical adherence as well as to integrate symptom management and palliative care strategies throughout the pre- and posttransplantation course.
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Affiliation(s)
- Emily M Rosenberger
- Department of Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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