1
|
Rebafka A, Bennett C, Dunn C, Roche D, Hawker C, Edwards D. Lung transplant recipients' experiences of and attitudes towards self-management: a qualitative systematic review. JBI Evid Synth 2024; 22:1656-1714. [PMID: 38757171 DOI: 10.11124/jbies-23-00070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE The objective of this review was to identify lung transplant recipients' experiences of and attitudes towards self-management. INTRODUCTION Lung transplantation is an established treatment to improve the survival of patients with end-stage lung diseases and has been performed on more than 40,000 patients worldwide. The current focus of care for lung transplant recipients is long-term management. Patients need to adapt and adhere to complex self-management tasks to prevent complications and to enable them to keep the transplanted graft as long as possible. However, to date, there are no qualitative systematic reviews that identify lung transplant recipients' experiences of and attitudes towards self-management. INCLUSION CRITERIA This review included studies of adults over 18 years of age who had received a lung transplant and were able to perform their self-management tasks independently. All studies that investigated lung transplant recipients' experiences of and attitudes towards self-management in any setting were eligible for inclusion. All types of studies that focused on qualitative data, including, but not limited to, phenomenology, grounded theory, ethnography, action research, and feminist research, were considered for inclusion. Mixed methods studies were included only when qualitative data could be extracted separately, and if they reported results relating to the phenomenon of interest. Studies published in English or German were considered for inclusion in this review. METHODS The search strategy aimed to find published studies using the databases Web of Science Core Collection, PsycINFO (Ovid), MEDLINE (Ovid), Embase (Ovid), Emcare (Ovid), and CINAHL (EBSCOhost). The search for unpublished studies included ProQuest Dissertations and Theses Database, EThOS, and OpenGrey. Databases were searched from inception to March 2022. Methodological quality of studies was independently assessed by 2 independent reviewers using the JBI checklist for qualitative research. A standardized data extraction tool from JBI was used by 2 reviewers for data collection. Meta-aggregation was undertaken to synthesize the data, and the final synthesis of the findings was reached through discussion. Results were graded according to ConQual. RESULTS Ten studies with a sample size from 8 to 73 participants from North America and Central/Northern Europe were included in the review. The critical appraisal scores of the included studies ranged from 3 to 9 out of 10. A total of 137 findings were extracted and aggregated to form 19 categories and the following 4 aggregated syntheses: i) Changes in routines, beliefs, and sense of responsibility are essential for better adaptation and self-management after lung transplantation; ii) Life after transplantation is characterized by both positive and negative feelings and experiences; iii) Better adjustment and self-management after a lung transplant require dealing with one's own feelings and beliefs; iv) After transplantation, engaging with relatives, friends, medical team, and donors is essential to improve experiences and adapt to being a transplant recipient. Based on the ConQual scores, 2 synthesized findings were graded as moderate and 2 were graded as low. CONCLUSIONS Nuanced emotional, social, relational, and psychological adjustment is required of lung transplant recipients to be able to successfully self-manage. Loved ones and health professionals contribute significantly to this process, but psychosocial or peer support may further facilitate this transition. SUPPLEMENTAL DIGITAL CONTENT A German-language version of the abstract of this review is available as Supplemental Digital Content [ http://links.lww.com/SRX/A46 ].
Collapse
Affiliation(s)
- Anne Rebafka
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff University, Cardiff, UK
- Center for Medicine, Medical Center, University Freiburg, Freiburg, Germany
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Clare Bennett
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff University, Cardiff, UK
| | - Catherine Dunn
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff University, Cardiff, UK
| | - Dominic Roche
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff University, Cardiff, UK
| | - Clare Hawker
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff University, Cardiff, UK
| | - Deborah Edwards
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff University, Cardiff, UK
| |
Collapse
|
2
|
Wang R, Peng F, Guo S, Sun J, Zhang S, Li X, Wei C, Liu H. Elements of Post-Transplant Recovery in Lung Transplant Recipients: A Scoping Review. Clin Nurs Res 2024; 33:481-492. [PMID: 38770918 DOI: 10.1177/10547738241253644] [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] [Indexed: 05/22/2024]
Abstract
To clarify and refine the specific elements of post-transplant recovery in lung transplant recipients, we explored the four dimensions of recovery: physiological, psychological, social, and habitual. This study is a scoping review. Two authors conducted a comprehensive electronic literature search to identify studies published from the establishment of the database to August 2022. Deductive coding was utilized to identify and categorize elements using a predefined list of the four components (physiological, psychological, social, and habitual recovery) based on the framework of post-transplant recovery proposed by Lundmark et al. Inductive coding was applied for concepts requiring further classification. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Systematic searching identified 8,616 potential records, of which 51 studies met the inclusion criteria. Ten subdimensions and their corresponding elements were identified and categorized into four dimensions of recovery following lung transplantation. The subdimensions included physiological recovery (including symptom experience, complications, physical function, and energy reserve), psychological recovery (encompassing affective distress, psychological adaptation, and transition from illness to health), social recovery (involving family adaptation and social adaptation), and habit recovery (focusing on health behavior).
Collapse
Affiliation(s)
- Ruiting Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Fucong Peng
- Beijing University of Chinese Medicine, Beijing, China
| | - Shaobo Guo
- Beijing University of Chinese Medicine, Beijing, China
| | - Jing Sun
- China-Japan Friendship Hospital, Beijing, China
| | - Shuping Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiangru Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Changyun Wei
- Beijing University of Chinese Medicine, Beijing, China
| | - Hongxia Liu
- Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
3
|
Farver-Vestergaard I, Frederiksen Y, Løkke A. COPD and Sexual Health: What the Sexual Medicine Clinician Needs to Know. J Sex Med 2022; 19:1725-1729. [PMID: 36151033 DOI: 10.1016/j.jsxm.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 01/06/2023]
Affiliation(s)
| | - Yoon Frederiksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Unit for Sexology, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
4
|
Polastri M, Dell’Amore A, Eden A, Pehlivan E. Does Preoperative Rehabilitation Influence the Quality of Life in Patients Who Are Candidates for Lung Transplant? EXP CLIN TRANSPLANT 2022; 20:543-548. [DOI: 10.6002/ect.2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
5
|
Farver-Vestergaard I, Frederiksen Y, Zachariae R, Rubio-Rask S, Løkke A. Sexual Health in COPD: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2022; 17:297-315. [PMID: 35173430 PMCID: PMC8842639 DOI: 10.2147/copd.s347578] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/14/2022] [Indexed: 01/07/2023] Open
Abstract
COPD has a profound impact on the lives of patients and their partners, but the influence on physical, psychological and social aspects of sexual health has not been reviewed systematically. Searches for studies of the impact of COPD on sexual health were conducted independently by two authors in the databases of PubMed, PsycINFO, Embases, CINAHL, Web of Science, Scopus and The Cochrane Library. English-language quantitative and qualitative studies assessing one or more aspects of sexual health in patients diagnosed with COPD were narratively reviewed and, when possible, subjected to meta-analytic evaluation. A total of 31 studies, including 4 qualitative, were included. Twelve studies assessing erectile dysfunction with the International Index of Erectile Function were subjected to meta-analysis. The pooled prevalence of erectile dysfunction was 74% (95% CI: 68-80%) in a total of 1187 patients with COPD, compared with 56% (37-73%) in 224 age-matched, non-COPD controls. The sexual health outcomes assessed in the remaining studies varied considerably, compromising the comparability of the results. None of the qualitative studies had sexual health as their primary focus. Compared with non-COPD individuals, erectile dysfunction appears to be more prevalent among patients with COPD, but more studies including non-COPD controls are needed to confirm this finding. In addition, the impact of COPD on other physical, psychological and social aspects of sexual health remains unclear due to the lack of comparable assessment methods and study designs.
Collapse
Affiliation(s)
| | - Yoon Frederiksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Unit for Sexology, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital, Aarhus, Denmark
| | - Sandra Rubio-Rask
- Department of Medicine, Vejle Hospital/Lillebaelt Hospital, Vejle, Denmark
| | - Anders Løkke
- Department of Medicine, Vejle Hospital/Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
6
|
Tang J, Kerklaan J, Wong G, Howell M, Scholes-Robertson N, Guha C, Kelly A, Tong A. Perspectives of solid organ transplant recipients on medicine-taking: Systematic review of qualitative studies. Am J Transplant 2021; 21:3369-3387. [PMID: 33866675 DOI: 10.1111/ajt.16613] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/16/2021] [Accepted: 04/02/2021] [Indexed: 01/25/2023]
Abstract
Medicine-taking among transplant recipients is a complex and ubiquitous task with significant impacts on outcomes. This study aimed to describe the perspectives and experiences of medicine-taking in adult solid organ transplant recipients. Electronic databases were searched to July 2020, and thematic synthesis was used to analyze the data. From 119 studies (n = 2901), we identified six themes: threats to identity and ambitions (impaired self-image, restricting goals and roles, loss of financial independence); navigating through uncertainty and distrust (lacking tangible/perceptible benefits, unprepared for side effects, isolation in decision-making); alleviating treatment burdens (establishing and mastering routines, counteracting side effects, preparing for the unexpected); gaining and seeking confidence (clarity with knowledge, reassurance through collective experiences, focusing on the future outlook); recalibrating to a new normal posttransplant (adjusting to ongoing dependence on medications, in both states of illness and health, unfulfilled expectations); and preserving graft survival (maintaining the ability to participate in life, avoiding rejection, enacting a social responsibility of giving back). Transplant recipients take medications to preserve graft function, but dependence on medications jeopardizes their sense of normality. Interventions supporting the adaptation to medicine-taking and addressing treatment burdens may improve patient satisfaction and capacities to take medications for improved outcomes.
Collapse
Affiliation(s)
- James Tang
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jasmijn Kerklaan
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Department of Pediatric Nephrology, Academic Medical Center, Emma Children's Hospital, Amsterdam, the Netherlands
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Ayano Kelly
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| |
Collapse
|
7
|
Rubio-Rask SE, Farver-Vestergaard I, Hilberg O, Løkke A. Sexual health communication in COPD: The role, contents and design of patient information leaflets. Chron Respir Dis 2021; 18:14799731211020322. [PMID: 34189938 PMCID: PMC8252346 DOI: 10.1177/14799731211020322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Understanding need for support and information among people with COPD is important for the delivery of patient-centred care. Especially regarding intimacy matters, many people wish to remain sexually active but may be struggling to find out how, as information and communication regarding sexual health is scarce. This is especially true when it comes to people with chronic obstructive pulmonary disease (COPD). The present review seeks to provide an overview of the role, contents and design of patient information leaflets (PILs) and discuss their application in sexual health communication for COPD. Based on the literature, a number of key points in the design of high-quality PILs are suggested, and important areas for the improvement of patients-clinician communication are highlighted. While PILs is a commonly used format to provide information in healthcare, other formats, e.g. video and podcasts, could be explored. Prioritizing the development of material to support communication in the future is necessary to address the needs of both patients and caregivers and to support clinicians in initiating conversations about sexual health and intimacy matters.
Collapse
Affiliation(s)
| | | | - Ole Hilberg
- Department of Medicine, Vejle Hospital, Vejle, Denmark
| | - Anders Løkke
- Department of Medicine, Vejle Hospital, Vejle, Denmark
| |
Collapse
|
8
|
The experiences of adult heart, lung, and heart-lung transplantation recipients: A systematic review of qualitative research evidence. PLoS One 2020; 15:e0241570. [PMID: 33175900 PMCID: PMC7657484 DOI: 10.1371/journal.pone.0241570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 10/18/2020] [Indexed: 11/19/2022] Open
Abstract
Aim To review evidence about the experience of being the recipient of a donated heart, lungs, or heart and lungs. Design A systematic review (registered with PROSPERO: CRD42017067218), in accordance with PRISMA guidelines. Data sources Seven databases and Google Scholar were searched in May 2017 and July 2019 for papers reporting English-language research that had used qualitative methods to investigate experiences of adult recipients. Review methods Quality was assessed and results were analysed thematically. Results 24 papers (reporting 20 studies) were eligible and included. Their results were organised into three chronological periods: pre-transplant (encompassing the themes of ‘dynamic psychosocial impact’, ‘resources and support’), transplant (‘The Call’, ‘intensive care unit’), and post-transplant (‘dynamic psychosocial impact’, ‘management’, ‘rejection’). Sub-themes were also identified. It was evident that contemplating and accepting listing for transplantation entailed or amplified realisation of the precipitating illness’s existential threat. The period surrounding transplantation surgery was marked by profound, often surreal, experiences. Thereafter, although life usually improved, it incorporated unforeseen challenges. The transplantation clinic remained important to the recipient. The meaning of the clinic and its staff could be both reassuring (providing care and support) and threatening (representing onerous medical requirements and potential organ rejection). Conclusion This review has implications for the psychosocial care of transplant recipients and indicates the need for further research to gain insight into the experience of receiving a donated heart and/or lung. Impact Medical consequences of heart and lung transplantation are well documented; this is the first systematic review of research using qualitative methods to investigate the experience of heart, lung, and heart-and-lung transplantation. The psychosocial impact of transplantation was found to be dynamic and complex, with notable features evident before, during, and after transplantation. Clinic staff remained significant to recipients. It is clear that recipients need continuing psychosocial as well as medical support.
Collapse
|
9
|
Rebafka A, Bennett C, Jones J, Carrier J, Kugler C, Edwards D. Lung transplant recipients' experiences of and attitudes towards self-management: a qualitative systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:831-837. [PMID: 29634507 DOI: 10.11124/jbisrir-2017-003524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION The question for this review is: what are lung transplant recipients' experiences of and attitudes towards self-management?
Collapse
Affiliation(s)
- Anne Rebafka
- Department of Internal Medicine, University Medical Centre Freiburg, Freiburg, Germany
- Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- The Wales Centre For Evidence Based Care: a Joanna Briggs Institute Centre of Excellence
| | - Clare Bennett
- The Wales Centre For Evidence Based Care: a Joanna Briggs Institute Centre of Excellence
- Institute of Health & Society, University of Worcester, Worcester, UK
| | - Jonathan Jones
- The Wales Centre For Evidence Based Care: a Joanna Briggs Institute Centre of Excellence
| | - Judith Carrier
- The Wales Centre For Evidence Based Care: a Joanna Briggs Institute Centre of Excellence
| | - Christiane Kugler
- Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Deborah Edwards
- The Wales Centre For Evidence Based Care: a Joanna Briggs Institute Centre of Excellence
| |
Collapse
|
10
|
Lundmark M, Erlandsson LK, Lennerling A, Almgren M, Forsberg A. Health transition after lung transplantation - a grounded theory study. J Clin Nurs 2016; 25:2285-94. [DOI: 10.1111/jocn.13269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Martina Lundmark
- Skåne University Hospital; Thoracic Intensive Care Unit; Lund Sweden
- Department of Health Sciences at Lund University; Lund Sweden
| | | | - Annette Lennerling
- The Transplant Center; Sahlgrenska University Hospital; Gothenburg Sweden
| | - Matilda Almgren
- Skåne University Hospital; Thoracic Intensive Care Unit; Lund Sweden
- Department of Health Sciences at Lund University; Lund Sweden
| | - Anna Forsberg
- Department of Health Sciences at Lund University; Lund Sweden
- Skåne University Hospital; Department of Transplantation and Cardiology; Lund Sweden
| |
Collapse
|
11
|
Patients’ Early Post-Operative Experiences with Lung Transplantation: A Longitudinal Qualitative Study. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2016; 9:547-557. [DOI: 10.1007/s40271-016-0174-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
12
|
Wray CM, Flores A, Padula WV, Prochaska MT, Meltzer DO, Arora VM. Measuring patient experiences on hospitalist and teaching services: Patient responses to a 30-day postdischarge questionnaire. J Hosp Med 2016; 11:99-104. [PMID: 26381606 PMCID: PMC4732908 DOI: 10.1002/jhm.2485] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/21/2015] [Accepted: 08/26/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Data comparing patient experiences between general medicine teaching and nonteaching hospitalist services are lacking. OBJECTIVE Evaluate hospitalized patients' experience on general medicine teaching and nonteaching hospitalist services by assessing patients' confidence in their ability to identify their physician(s), understand their roles, and their rating of the coordination and overall care. METHODS Retrospective cohort analysis of general medicine teaching and nonteaching hospitalist services from 2007 to 2013 at an academic medical center. Patients were surveyed 30-days after hospital discharge regarding their confidence in their ability to identify their physician(s), understand the role of their physician(s), and their perceptions of coordination and overall care. A 3-level, mixed effects logistic regression was performed to ascertain the association between service type and patient-reported outcomes. RESULTS Data from 4591 general medicine teaching and 1811 nonteaching hospitalist service patients demonstrated that those cared for by the hospitalist service were more likely to report being able to identify their physician (50% vs 45%, P < 0.001), understand their role (54% vs 50%, P < 0.001), and rate greater satisfaction with coordination (68 vs 64%, P = 0.006) and overall care (73% vs 67%, P < 0.001). In regression models, the hospitalist service was associated with higher ratings in overall care (odds ratio [OR]: 1.33; 95% confidence interval [CI]: 1.15-1.47), even when hospitalists were the attendings on general medicine teaching services (OR: 1.17; 95% CI: 1.01-1.31). CONCLUSION Patients on a nonteaching hospitalist service rated their overall care slightly better than patients on a general medicine teaching service. Team structure and complexity may play a role in this difference.
Collapse
Affiliation(s)
- Charlie M. Wray
- Section of Hospital Medicine, University of Chicago Medical Center
| | - Andrea Flores
- Section of Hospital Medicine, University of Chicago Medical Center
| | | | | | - David O. Meltzer
- Section of Hospital Medicine, University of Chicago Medical Center
- Department of Economics and the Harris School of Public Policy Studies
| | - Vineet M. Arora
- Pritzker School of Medicine, University of Chicago
- Section of General Internal Medicine, University of Chicago Medical Center
| |
Collapse
|
13
|
Fox KR, Posluszny DM, DiMartini AF, DeVito Dabbs AJ, Rosenberger EM, Zomak RA, Bermudez C, Dew MA. Predictors of post-traumatic psychological growth in the late years after lung transplantation. Clin Transplant 2014; 28:384-93. [PMID: 24750288 DOI: 10.1111/ctr.12301] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although lung transplantation improves quality of life, most psychosocial research focuses on adverse psychological and social functioning outcomes. Positive effects, particularly in the late-term years as physical morbidities increase, have received little attention. We provide the first data on a psychological benefit - post-traumatic growth (PTG) - and we focused on long-term (>5 yr) survivors. METHODS Among 178 patients from a prospective study of mental health during the first two yr post-transplant, we recontacted survivors 6-11 yr post-transplant. We assessed PTG (i.e., positive psychological change resulting from the transplant) and examined its relationship to other patient characteristics with multivariable regression analyses. RESULTS Sixty-four patients (86% of survivors) were assessed (M = 8.1 yr post-transplant, SD = 1.2). Mean PTG exceeded the scale's midpoint (M = 38.6, SD = 10.0; scale midpoint = 25). Recipients experiencing greater PTG were female (p = 0.022), less educated (p = 0.014), and had a history of post-transplant panic disorder (p = 0.005), greater friend support (p = 0.048), and better perceived health (p = 0.032). Neither other pre- or post-transplant mood and anxiety disorders nor transplant-related morbidities (acute rejection, bronchiolitis obliterans syndrome) predicted PTG. CONCLUSIONS PTG exceeded levels observed in other chronic disease populations, suggesting that lung transplantation may uniquely foster positive psychological change in long-term survivors. PTG occurs despite physical and psychiatric morbidities. Whether PTG promotes other positive post-transplant psychosocial outcomes deserves attention.
Collapse
Affiliation(s)
- Kristen R Fox
- Department of Psychology, Ohio University, Athens, OH, USA
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Fernando DK, McIntosh AM, Bladin PF, Wilson SJ. Common experiences of patients following suboptimal treatment outcomes: implications for epilepsy surgery. Epilepsy Behav 2014; 33:144-51. [PMID: 24681640 DOI: 10.1016/j.yebeh.2014.02.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 02/12/2014] [Accepted: 02/14/2014] [Indexed: 10/25/2022]
Abstract
Few studies have investigated the patient experience of unsuccessful medical interventions, particularly in the epilepsy surgery field. The present review aimed to gain insight into the patient experience of seizure recurrence after epilepsy surgery by examining the broader literature dealing with suboptimal results after medical interventions (including epilepsy surgery). To capture the patient experience, the literature search focused on qualitative research of patients who had undergone medically unsuccessful interventions, published in English in scholarly journals. Twenty-two studies were found of patients experiencing a range of suboptimal outcomes, including seizure recurrence, cancer recurrence and progression, unsuccessful joint replacement, unsuccessful infertility treatment, organ transplant rejection, coronary bypass graft surgery, and unsuccessful weight-loss surgery. In order of frequency, the most common patient experiences included the following: altered social dynamics and stigma, unmet expectations, negative emotions, use of coping strategies, hope and optimism, perceived failure of the treating team, psychiatric symptoms, and control issues. There is support in the epilepsy surgery literature that unmet expectations and psychiatric symptoms are key issues for patients with seizure recurrence, while other common patient experiences have been implied but not systematically examined. Several epilepsy surgery specific factors influence patient perceptions of seizure recurrence, including the nature of postoperative seizures, the presence of postoperative complications, and the need for increased postoperative medications. Knowledge of common patient experiences can assist in the delivery of patient follow-up and rehabilitation services tailored to differing outcomes after epilepsy surgery.
Collapse
Affiliation(s)
- Dinusha K Fernando
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville 3010, Australia
| | - Anne M McIntosh
- Melbourne Brain Centre, Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia; Epilepsy Research Centre, Department of Medicine, Austin Health, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Austin Health, Melbourne, Australia
| | - Peter F Bladin
- Comprehensive Epilepsy Program, Austin Health, Melbourne, Australia
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville 3010, Australia; Epilepsy Research Centre, Department of Medicine, Austin Health, The University of Melbourne, Australia; Comprehensive Epilepsy Program, Austin Health, Melbourne, Australia.
| |
Collapse
|
15
|
Steinke EE. Sexuality and chronic illness. J Gerontol Nurs 2013; 39:18-27; quiz 28-9. [PMID: 24066783 DOI: 10.3928/00989134-20130916-01] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/15/2013] [Indexed: 11/20/2022]
Abstract
Sexual function is often affected in individuals living with chronic illness and their partners, and multiple comorbidities increase the likelihood of sexual dysfunction. This review focuses on the areas of cardiovascular disease, respiratory conditions, and cancer, all areas for which there are practical, evidence-based strategies to guide sexual counseling. Although nurses have been reluctant to address the topic of sexuality in practice, a growing number of studies suggest that patients want nurses to address their concerns and provide resources to them. Thus, nurses must be proactive in initiating conversations on sexual issues to fill this gap in practice.
Collapse
|
16
|
Dilling DF, Glanville AR. Advances in lung transplantation: the year in review. J Heart Lung Transplant 2011; 30:247-51. [PMID: 21211995 DOI: 10.1016/j.healun.2010.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Accepted: 12/05/2010] [Indexed: 10/18/2022] Open
Abstract
This article introduces a new offering from the Journal, with analysis of the key publications in lung transplantation (LTx) over the past year. To assemble the list of citations, a MEDLINE search was performed using the keyword "lung transplantation" with dates of publication from July 2009 through June 2010. In addition, tables of contents for major journals covering organ transplantation, respiratory diseases and thoracic surgery were reviewed to identify any reports not picked up by the MEDLINE search. Articles were chosen by the authors for their perceived impact on the care of LTx patients or their relevance to understanding the pathophysiology of complications after LTx.
Collapse
Affiliation(s)
- Daniel F Dilling
- Division of Pulmonary and Critical Care, Loyola University Chicago, Maywood, Illinois, USA
| | | |
Collapse
|