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Garrido-Bolton J, Alcamí-Pertejo M, de la Vega R, Hernández-Oliveros F, Pérez-Martínez A, Bravo-Ortiz MF, Fernández-Jiménez E. Neuropsychological and biopsychosocial evolution, therapeutic adherence and unmet care needs during paediatric transplantation: study protocol of a mixed-methods design (observational cohort study and focus groups) - the TransplantKIDS mental health project. Front Psychol 2024; 15:1308418. [PMID: 38449767 PMCID: PMC10915199 DOI: 10.3389/fpsyg.2024.1308418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/11/2024] [Indexed: 03/08/2024] Open
Abstract
The present article describes the protocol of a mixed-methods study (an observational cohort design and focus groups), aimed to examine neuropsychological functioning and other biopsychosocial outcomes, therapeutic adherence and unmet care needs in paediatric population undergoing solid organ or allogeneic hematopoietic transplant during the pre- and post-transplant phases. Following a multi-method/multi-source approach, neuropsychological domains will be comprehensively measured with objective tests (SDMT, K-CPT 2/CPT 3, TAVECI/TAVEC, WISC-V/WAIS-IV Vocabulary and Digit Span subtests, Verbal Fluency tests, Stroop, ROCF, and TONI-4); ecological executive functioning, affective and behavioral domains, pain intensity/interference, sleep quality and therapeutic adherence will be assessed through questionnaires (parent/legal guardians-reported: BRIEF-2 and BASC-3; and self-reported: BASC-3, BPI, PROMIS, AIQ and SMAQ); and blood levels of prescribed drugs will be taken from each patient's medical history. These outcomes will be measured at pre-transplant and at 4-weeks and 6-months post-transplant phases. The estimated sample size was 60 patients (any type of transplant, solid organ, or hematopoietic) from La Paz University Hospital (Madrid, Spain). Finally, three focus group sessions will be organized with patients, parents/guardians, and transplant clinicians (n = 15, with 5 participants per group), in order to qualitatively identify unmet care needs during the pre-, and post-transplant stages of the process. The study protocol was registered at ClinicalTrials.gov (NCT05441436).
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Affiliation(s)
- Jessica Garrido-Bolton
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Margarita Alcamí-Pertejo
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Rocío de la Vega
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga, Málaga, Spain
- Instituto Biomédico de Málaga – IBIMA Plataforma Bionand, Málaga, Spain
| | | | - Antonio Pérez-Martínez
- Department of Pediatric Hemato-Oncology, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Faculty of Social Sciences and Communication, Universidad Europea de Madrid, Madrid, Spain
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Zhang D, Chang T, Zhao K, Wei H, Feng S, Li X. The mediating effect of sense of coherence on the caregiver ability-caregiver burden relationship for caregivers of children with liver transplantation in China. J Pediatr Nurs 2023; 73:72-77. [PMID: 37647791 DOI: 10.1016/j.pedn.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Caregivers of children who have had liver transplantation often experience chronic care stress. Previous studies have focused on caregivers' negative feelings (e.g., caregiver burden), but few studies have focused on caregivers' positive feelings (e.g., sense of coherence) and caregiver ability. OBJECTIVES The study purpose was to investigate the status of the burden of caregivers of children with liver transplantation, and to explore the mediating role of sense of coherence between caregiver ability and caregiver burden. METHODS There were 461 questionnaires collected from a tertiary-level hospital from caregivers of children who had liver transplantation from April to June 2022. Demographic data, Family Caregiver Task Inventory, Sense of Coherence Scale-13, and Zarit Burden Interview were used. The STROBE checklist was monitored. RESULTS The average caregiver burden score was 32.19 ± 16.71. The distribution of caregiver burden levels was mild (42.52%), none (26.25%), moderate (24.95%), and severe (6.29%). Caregiver ability score was negatively correlated with caregiver burden score; however, sense of coherence score was negatively correlated with caregiver burden score. Caregiver ability partially mediated caregiver burden through sense of coherence (38.51%). CONCLUSION The caregiver burden level was not heavy in general. Both positive and negative feelings were present in caregivers. Caregiver ability also reduced the caregiver burden through sense of coherence.
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Affiliation(s)
- Dan Zhang
- School of Medicine, HuangHuai University, Zhumadian, Henan, PR China; Transplantation and Hepatobiliary Department, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Tiantian Chang
- Transplantation and Hepatobiliary Department, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Nursing department, China-Japan Friendship Hospital, Beijing, PR China
| | - Kaijian Zhao
- School of Medicine, HuangHuai University, Zhumadian, Henan, PR China
| | - He Wei
- Transplantation and Hepatobiliary Department, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Shuang Feng
- Transplantation and Hepatobiliary Department, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Xiaofei Li
- Transplantation and Hepatobiliary Department, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China.
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Bastos Tavares AP, Seixas LBPDMG, Jayme CLW, Porta G, Seixas RBPDM, de Carvalho E. Pediatric Liver Transplantation: Caregivers' Quality of Life. Pediatr Gastroenterol Hepatol Nutr 2022; 25:489-499. [PMID: 36451695 PMCID: PMC9679308 DOI: 10.5223/pghn.2022.25.6.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/29/2022] [Accepted: 10/03/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The survival rate of pediatric patients undergoing liver transplantation has increased considerably. Despite this, the period after transplantation is still complex and poses several challenges to the recipient's family, which is responsible for care management. Recently, more attention has been paid to the impact of this complex procedure on the quality of life of caregivers. Hence, this study is aimed at assessing the quality of life of caregivers of patients who have undergone liver transplantation and the aspects that influence it. METHODS This was an observational and cross-sectional study. From November 2020 to January 2021, short-form-36 questionnaires and additional questions were given to the main caregivers of children and adolescents who underwent pediatric liver transplantation. RESULTS Thirty-eight questionnaires were completed and the results revealed a lower quality of life in comparison to Brazilian standards, primarily in the mental domains (41.8±14.1 vs. 51.1±2.8; p<0.001). It did not show a significant association with socioeconomic or transplant-related factors, but it did show a negative impact on parents' perception of the child's health. Parents who reported worse health status for their children had a lower mental quality of life (44.1±13.8 vs. 33.3±12.6; p<0.05). CONCLUSION The caregivers of transplanted children have a lower quality of life than those of the local population. Psychological assistance should be routinely provided to parents for long-term follow-up to mitigate potential negative effects on the transplanted child's care.
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Affiliation(s)
- Ana Paula Bastos Tavares
- Department of Pediatric Gastroenterology, Brasília José de Alencar Children's Hospital, Brasília, Brazil
| | | | | | - Gilda Porta
- Department of Pediatric Hepatology and Liver Transplantation, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | | | - Elisa de Carvalho
- Department of Pediatric Gastroenterology, Brasília José de Alencar Children's Hospital, Brasília, Brazil
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Düken ME, Zengin M, Yayan EH. The effect of perceived social support on the psychosocial status of parents whose child had liver transplantation. J Pediatr Nurs 2022; 66:e130-e136. [PMID: 35527086 DOI: 10.1016/j.pedn.2022.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this study was to describe parental psychosocial outcomes following paediatric liver transplantation and the relationship between parental psychosocial outcomes and social support. METHOD This is a correlational, descriptive study conducted between April 2021 and October 2021 in the paediatric hepatology polyclinics of the liver transplantation institute of a university hospital. The SPSS 25 and AMOS 23 package programmes were used to perform data analyses. RESULTS Data analysis revealed that the parents' social support level was low (44.6 ± 14.8), while their levels of trait anxiety (51.5 ± 4.8) and loneliness (48.5 ± 5.4) were high, and their depression level was moderate (26.4 ± 5.8). Established structural equation modelling demonstrated that the social support parents received had a significant effect on their levels of loneliness (β = -0.88; p < 0.001), trait anxiety (β = -0.37; p < 0.001), and depression (β = -0.44; p < 0.001). CONCLUSION The authors conclude that in parents of children who have had a liver transplant, increased levels of perceived social support result in decreased levels of anxiety, loneliness, and depression. PRACTICE IMPLICATIONS The authors recommend that healthcare professionals can contribute to reducing the anxiety, loneliness and depression in parents of paediatric liver transplant recipients by strengthening their social support systems.
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Affiliation(s)
- Mehmet Emin Düken
- Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Harran University, Şanlıurfa, Turkey
| | - Mürşide Zengin
- Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Adıyaman University, Adıyaman, Turkey.
| | - Emriye Hilal Yayan
- Department of Child Health and Diseases Nursing, Faculty of Nursing, İnönü University, Malatya, Turkey
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Amatya K, Monnin K, Steinberg Christofferson E. Psychological functioning and psychosocial issues in pediatric kidney transplant recipients. Pediatr Transplant 2021; 25:e13842. [PMID: 33012109 DOI: 10.1111/petr.13842] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022]
Abstract
Research demonstrates that psychological factors are important for positive transplant outcomes, though there is little literature that synthesizes these factors in a comprehensive model among pediatric kidney transplant patients. This review analyzes psychological and psychosocial factors related to medical outcomes and overall well-being post-transplant by utilizing the PPPHM and referencing the existing literature on risk and resilience. Pediatric kidney transplant recipients are more susceptible to mental health concerns such as depression, anxiety, and ADHD, as well as developmental and neurocognitive delays, compared to healthy peers. Complex medical care and psychosocial needs for patients have implications for family functioning, parental and sibling mental health, and youth readiness to transition to adult care. It is important to carefully monitor patient functioning with empirically validated tools and to intervene in a multidisciplinary setting as early as possible to identify patients at risk and reduce potential negative impact. Psychologists are uniquely trained to assess and address these issues and are a valuable component of multidisciplinary, culturally competent care. While research in this expansive field is improving, more data are needed to establish gold standard approaches to mental health and psychosocial care in this population.
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Affiliation(s)
- Kaushalendra Amatya
- Divisions of Nephrology and Cardiology, Children's National Hospital, Washington, DC, USA.,Pediatrics and Psychiatry & Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Kara Monnin
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Elizabeth Steinberg Christofferson
- Solid Organ Transplant Surgery, Children's Hospital Colorado, Aurora, CO, USA.,Departments of Psychiatry and Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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Divdar Z, Foroughameri G, Farokhzadian J, Sheikhbardsiri H. Psychosocial Needs of the Families With Hospitalized Organ Transplant Patients in an Educational Hospital in Iran. Ther Apher Dial 2019; 24:178-183. [PMID: 31373767 DOI: 10.1111/1744-9987.13425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/25/2019] [Accepted: 07/31/2019] [Indexed: 12/17/2022]
Abstract
Nurses are required to understand and meet the physiological needs of the family members of the patients hospitalized in transplant wards of the hospitals. Considering the importance of this issue, this study aimed to investigate the psychosocial needs of the families with an organ transplant patient. The study employed a cross-sectional design and was conducted in Afzalipour Educational Hospital affiliated to the Kerman University of Medical Sciences in 2018. The 45-item questionnaire of the psychosocial needs was applied to assess the psychosocial needs of the families with an organ transplant patient, including kidney, liver, and bone marrow. The quota sampling method was used and 230 participants completed the survey. Data were analyzed using descriptive mean and SD and analytical statistics independent t-test, anova, and Pearson's correlation coefficient tests by SPSS 22 (version 22, SPSS, Chicago Inc., IL). The results indicated that the mean scores of psychological needs of families with transplanted patients hospitalized in three wards of bone marrow, kidney, and liver were at a high level (143/16 ± 12/29). The mean scores of psychosocial needs in the bone marrow transplantation ward (148/60 ± 8/18) were significantly higher than those of the patients hospitalized in the liver (141/24 ± 16/41) and kidney (141/25 ± 11/30) wards. A significant difference was observed among the three wards of the liver, kidney, and bone marrow transplantation with regard to the provided support, information, and proximity. To improve the psychological needs of the family members with patients hospitalized in transplant wards and reduce their mental reactions, they should be provided with more precise information about the patient's treatment procedure.
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Affiliation(s)
- Zahra Divdar
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Golnaz Foroughameri
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Hojjat Sheikhbardsiri
- Department of Emergency Operation Center (EOC), Disasters and Emergencies Management Center, Kerman University of Medical Sciences, Kerman, Iran
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A Comparison of Caregiving Burden and Social Support Levels of Parents of Children Undergoing Liver Transplant. J Pediatr Nurs 2019; 47:e45-e50. [PMID: 31064678 DOI: 10.1016/j.pedn.2019.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 04/20/2019] [Accepted: 04/20/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE This study was conducted to compare caregiving burden and social support levels of parents of children who have undergone a liver transplant. DESIGNS AND METHODS This study utilized a descriptive, cross-sectional research design. Data were collected using a parent information form, the Zarit Burden Interview, and the Multidimensional Scale of Perceived Social Support. Data were collected via face-to-face interview after written consent was obtained from the parents of children who had received a liver transplant. RESULTS Parent participants were found to have a high caregiving burden and low levels of social support from their surroundings. Parents who experienced change in their work life, social and family relationships, and had economic problems post-transplant, had a higher caregiving burden and may have lower social support. Parents whose children had a transplant from a cadaveric donor and continued to attend school were found to have a lower caregiving burden. There was a negative correlation between parent caregiving burden and social support scores; that is, caregiving burden (R2 = 0.57, p < 0.01) was significantly affected by social support (B = -0.682, β = -0.757). CONCLUSIONS This study concluded that parents receiving social support may have a lower caregiving burden, and some of their socio-demographic characteristics may have a positive effect on social support and caregiving burden. PRACTICE IMPLICATIONS Health professionals need to pay special attention to the social support and caregiving burden of parents whose children have had an organ transplant.
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Christian BJ. Translational Research-Enhancing the Health of Children and their Parents. J Pediatr Nurs 2015; 30:516-8. [PMID: 25939568 DOI: 10.1016/j.pedn.2015.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 03/30/2015] [Indexed: 10/23/2022]
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