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Brunner K, Weisschuh L, Jobst S, Kugler C, Rebafka A. Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study. NURSING REPORTS 2024; 14:961-987. [PMID: 38651485 PMCID: PMC11036239 DOI: 10.3390/nursrep14020073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
Patients with Solid Organ Transplantations (SOTx) face long-term lifestyle adaptations, psychological and social adjustments, and complex self-care regimes to maintain health post-transplant. Self-management (SM) skills represent important aspects of nursing communication with SOTx patients; however, there is potential for SM to be defined narrowly in terms of medication adherence. The study presented here collated the existing definitions in a mixed method review in order to identify SM attributes for this group (including those unique to this population). Secondary analysis of a dataset and bibliographic analysis and an expert panel were used to develop a comprehensive working definition of SOTx patients. The analysis comprised critical interpretation of the evolving definition content, concepts, and contexts of application in current usages and over time. We identified eight definitions and 63 cited definition sources from bibliographic analysis. Findings identified limitations of the existing definitions. Population-specific attributes included optimisation of transplant outcomes, active engagement in healthy behaviours, control, structure, and discipline characteristics, and moderating factors of patient motivation, self-efficacy, and cognitive function. A critical appraisal of definitions indicated inadequately defined aspects such as setting, temporal dimension, concept interaction, interventions, and measurable outcomes. The bibliographic analysis highlighted the influence of broader chronic illness constructions of SM, underpinning the generalisable SM attributes in current definitions. Further research may advance the development of a definition in exploring the relevance of SOTx-specific attributes of the definition.
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Affiliation(s)
| | | | | | | | - Anne Rebafka
- Institute of Nursing Science, University Medical Centre, Albert-Ludwigs University Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany (S.J.); (C.K.)
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Sung C, Hershberger PE, Lockwood MB. Sickness Symptoms in Kidney Transplant Recipients: A Scoping Review. West J Nurs Res 2023; 45:344-362. [PMID: 36333867 PMCID: PMC10853985 DOI: 10.1177/01939459221128125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sickness symptoms (depressive symptoms, anxiety, and fatigue) are common among people with chronic illness, often presenting as a symptom cluster. Sickness symptoms persist in many patients with chronic kidney disease, even after kidney transplantation (KT); however, little is known about sickness symptom-induced burden in KT recipients. This scoping review synthesizes available evidence for sickness symptoms in KT recipients, including findings on symptom prevalence, predictors, outcomes, interrelationships, and clustering. Among 38 reviewed studies, none identified sickness symptoms as a cluster, but we observed interrelationships among the symptoms examined. Fatigue was the most prevalent sickness symptom, followed by anxiety and depressive symptoms. Predictors of these symptoms included demographic, clinical, and psychosocial factors, and health-related quality of life was the most researched outcome. Future research should use common data elements to phenotype sickness symptoms, include biological markers, and employ sophisticated statistical methods to identify potential clustering of sickness symptoms in KT recipients.
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Affiliation(s)
- Choa Sung
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - Mark B. Lockwood
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Mulder MB, Doga B, Borgsteede SD, van den Burg AM, Metselaar HJ, den Hoed CM, Hunfeld NGM. Evaluation of medication-related problems in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist: a cohort study. Int J Clin Pharm 2022; 44:1114-1122. [PMID: 36100818 PMCID: PMC9618499 DOI: 10.1007/s11096-022-01423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
Background Transplant recipients undergo significant changes in their medication regimen during follow-up and are at an increased risk for medication-related problems (MRPs). Aim This study aimed to compare the prevalence and types of MRPs and interventions in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist as well as the satisfaction with information about medicines and medication adherence. Method We performed a single-center, observational cohort study. A retro- and prospective cohort were used and subdivided in a group that did and did not receive a medication consultation. The prevalence and types of MRPs and interventions were identified and categorized. The satisfaction parameters were evaluated using validated questionnaires. Results Included were 291 patients. In total, 368 MRPs were identified in 197 patients in the non-medication consultation cohort (median 1; range 1–3 per patient) and 248 MRPs in 94 patients in the medication consultation cohort (median 2; range 1–4 per patient). In the medication consultation cohort, significantly fewer MRPs as unnecessary drugs (17.3% versus 58.7%, p < 0.001), suboptimal therapy (2.4% versus 9.5%, p < 0.001), untreated indication (2.8% versus 6.8%, p = 0.040) and underdosed drugs (0.4% versus 6.3%, p < 0.001) were identified. In the non-medication consultation cohort significantly more patients used unnecessary drugs (72.1% versus 39.4%, p < 0.001) compared to the medication consultation cohort. Patients in both cohorts are satisfied with the information about medicines and reported a high medication adherence. Conclusion Patients in the medication consultation cohort had significantly fewer MRPs and used significantly less unnecessary drugs. Including a clinical pharmacist to the post-transplant care has an added value. Supplementary information The online version contains supplementary material available at 10.1007/s11096-022-01423-6.
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Affiliation(s)
- Midas B Mulder
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
- Department of Pharmacy, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3015 GD, Rotterdam, The Netherlands.
| | - B Doga
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S D Borgsteede
- Department of Clinical Decision Support, Health Base Foundation, Houten, The Netherlands
| | - A M van den Burg
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - H J Metselaar
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - C M den Hoed
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - N G M Hunfeld
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Intensive Care, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Matos DOD, Medeiros-Souza P, Melo RPD, Menezes RAD, Tavares NUL. Satisfação dos responsáveis por adolescentes com as informações recebidas para o uso dos psicotrópicos em Unidade de Saúde Mental. REVISTA PAULISTA DE PEDIATRIA 2022. [DOI: 10.1590/1984-0462/2022/40/2021012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resumo Objetivo: Analisar a satisfação dos responsáveis por adolescentes com as informações recebidas para o uso dos medicamentos psicofármacos. Métodos: Estudo transversal realizado em ambulatório de referência entre 2017 e 2019, em Brasília, com 173 responsáveis por adolescentes diagnosticados com transtornos mentais e comportamentais em uso de psicofármacos. O questionário Satisfaction with Information about Medicines Scale (SIMS) foi utilizado para identificar o grau de satisfação em relação às informações recebidas sobre os medicamentos. Resultados: A maioria dos responsáveis estava insatisfeita quanto às informações recebidas sobre psicofármacos (n=112; 64,7%). Destacou-se a insatisfação com as informações sobre potenciais problemas do medicamento (n=127; 73,4%), quando comparada à ação e ao uso (n=89; 51,5%). As informações sobre o impacto do medicamento na vida sexual do adolescente foram consideradas insatisfatórias ou inexistentes. Conclusões: A satisfação dos responsáveis com as informações recebidas sobre psicofármacos foi baixa. Os participantes demonstraram insatisfação com as informações sobre potenciais problemas, especialmente às relacionadas ao impacto na vida sexual dos adolescentes.
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Matos DOD, Medeiros-Souza P, Melo RPD, Menezes RAD, Tavares NUL. Parents’ satisfaction with information received on psychotropic drugs used by adolescents in a Mental Health Unit. REVISTA PAULISTA DE PEDIATRIA 2022; 40:e2021012. [PMID: 35584415 PMCID: PMC9113626 DOI: 10.1590/1984-0462/2022/40/2021012in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/23/2021] [Indexed: 11/22/2022]
Abstract
Abstract Objective: To analyze the satisfaction of those responsible for adolescents with information received for the use of psychotropic drugs. Methods: Cross-sectional study carried out in a reference outpatient clinic in Brasília between 2017 and 2019. It involved 173 legal representatives of adolescents diagnosed with Mental and Behavioral Disorders using psychotropic drugs. In order to identify the level of satisfaction about the information received on psychotropic drugs, the Satisfaction with Information about Medicines Scale (SIMS) was used. Results: Most guardians were dissatisfied with the information received on psychotropic drugs (n=112; 64.7%). The dissatisfaction with information about potential problems of medication was the one that stood out the most (n=127; 73.4%) when compared to information about action and usage (n=89; 51.5%). Participants considered information on the impact of medication on the adolescent’s sexual life unsatisfactory or nonexistent. Conclusions: The parents’ satisfaction with the information received about psychotropic drugs was low. Participants showed dissatisfaction with the information about potential problems, especially related to the impact on the sexual life of their tutored.
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Schirutschke H, Gross P, Paliege A, Hugo C. 10-Year Evaluation of Adherence and Satisfaction with Information about Tolvaptan in ADPKD: A Single-Center Pilot Study. Patient Prefer Adherence 2021; 15:1941-1952. [PMID: 34511889 PMCID: PMC8427080 DOI: 10.2147/ppa.s325738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Tolvaptan is the only approved drug for the treatment of autosomal dominant polycystic kidney disease (ADPKD) and causes significant polyuria with secondary polydipsia. Up to now, there is no study that examines tolvaptan adherence and satisfaction with information received about tolvaptan in ADPKD patients 10 years after starting tolvaptan therapy. PATIENTS AND METHODS This pilot study includes 12 ADPKD patients that were formerly enrolled in the tolvaptan registration trials and have continued to use tolvaptan thereafter. Data were collected once via questionnaires on patients' self-reported adherence (MARS-D: Medication Adherence Report Scale - German version) and satisfaction with the information received about tolvaptan (SIMS-D: Satisfaction with Information about Medicines Scale - German version) at the time of the present study. In addition, serum creatinine levels and clinical data were evaluated. RESULTS The MARS-D demonstrated strong adherence to tolvaptan (range of possible score: 5-25; median: 23.5; range of individual results: 5). The SIMS-D showed a high level of satisfaction with the information received about the action and usage of tolvaptan (SIMS-D AU subscale; range of possible score: 0-9; median: 9, range of individual results: 1), but also revealed dissatisfaction regarding the information received about potential problems of tolvaptan in 42% of the participants (SIMS-D PP subscale; range of possible score: 0-8; median: 8, range of individual results: 6). During treatment with tolvaptan, the eGFR decreased from 78.8 ± 15.9 mL/min/1.73 m2 to 48.3 ± 19.4 mL/min/1.73 m2 (P < 0.0001). CONCLUSION Although patients reported strong adherence to tolvaptan, there was still dissatisfaction with the information received about potential problems with tolvaptan. Therefore, our data suggest conduction of at least one patient survey on adherence and satisfaction with the information received about tolvaptan during any tolvaptan treatment to improve patient education regarding the use of tolvaptan in slowing down of ADPKD.
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Affiliation(s)
- Holger Schirutschke
- University Hospital Carl Gustav Carus at the Technische, Universität Dresden, Department of Internal Medicine III, Division of Nephrology, Dresden, Germany
| | - Peter Gross
- University Hospital Carl Gustav Carus at the Technische, Universität Dresden, Department of Internal Medicine III, Division of Nephrology, Dresden, Germany
| | - Alexander Paliege
- University Hospital Carl Gustav Carus at the Technische, Universität Dresden, Department of Internal Medicine III, Division of Nephrology, Dresden, Germany
| | - Christian Hugo
- University Hospital Carl Gustav Carus at the Technische, Universität Dresden, Department of Internal Medicine III, Division of Nephrology, Dresden, Germany
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Yang FC, Chen HM, Huang CM, Hsieh PL, Wang SS, Chen CM. The Difficulties and Needs of Organ Transplant Recipients during Postoperative Care at Home: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165798. [PMID: 32796529 PMCID: PMC7459921 DOI: 10.3390/ijerph17165798] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
With recent advances in surgery and immunosuppressive drugs, organ transplantation has become a major treatment for irreversible organ failure. However, organ transplant recipients returning home after operation may face ongoing physiological, psychological, and social difficulties. To increase recipients’ quality of life, postoperative care at home is critical. Thus, the aim of this systematic literature review was to explore recipients’ difficulties and needs during postoperative care at home. Our search conformed to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and returned 23 relevant articles published from 1997–2020 in PubMed, MEDLINE, EBSCO, Cochrane, ProQuest, and CEPS, which were assessed using the Modified Jadad Scale or the 32 Consolidated Criteria for Reporting Qualitative Research (COREQ) appraisal indices and then synthesized through narration. The most common difficulties faced were psychological difficulties, followed by physiological, social, and other difficulties; the most common needs were psychological needs, followed by education and information training, social, and other needs. These results demonstrated that healthcare professionals can do more to provide patients with comprehensive care and promote successful self-management and quality of life at home. They also confirmed that collaboration between transplant teams, caregivers, and patients is necessary to optimize postoperative outcomes. We suggest that customized care may promote postoperative patients’ self-management and quality of life at home.
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Affiliation(s)
- Fu-Chi Yang
- College of General Education, National Chin-Yi University of Technology, Taichung 41170, Taiwan;
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Hsiao-Mei Chen
- Department of Nursing, Chung Shan Medical University, Taichung 40201, Taiwan;
| | - Chiu-Mieh Huang
- Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei 11221, Taiwan;
| | - Pei-Lun Hsieh
- Department of Nursing, College of Health, National Taichung University of Science and Technology, Taichung 40343, Taiwan;
| | - Shoei-Shen Wang
- Department of Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan;
- College of Medicine, National Taiwan University, Taipei 100233, Taiwan
- Department of Surgery, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan
- School of Medicine, Fu Jen Catholic University College of Medicine, New Taipei City 242062, Taiwan
| | - Ching-Min Chen
- Department of Nursing, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Correspondence:
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