Problemas psicológicos asociados al trasplante de órganos

International Journal of Clinical and Health Psychology 01/2005;
Source: DOAJ

ABSTRACT El trasplante de órganos es una alternativa terapéutica para aquellos pacientes que tienen problemas graves en el funcionamiento de un órgano vital: corazón, hígado, pulmón, etc. Dada la relevancia de este tema, en el presente estudio teórico analizamos los principales problemas psicológicos asociados al trasplante de órganos. Concretamente, hemos tenido en cuenta los siguientes apartados: 1) Repercusiones psicológicas del trasplante de órganos en los pacientes: delirium, trastornos sexuales, trastornos del estado de ánimo, trastornos de ansiedad, fantasías sobre el donante, insatisfacción con la imagen corporal y otros trastornos; 2) variables psicosociales que influyen en las repercusiones psicológicas asociadas al trasplante de órganos: apoyo familiar, trastornos psicológicos en los familiares, hospitalización, expectativas pre y post-trasplante, estrategias de afrontamiento, duración de la enfermedad, etiología del trasplante, procedencia del órgano implantado y otras variables; 3) fases psicológicas en los trasplantados renales, hepáticos y cardíacos en función de diferentes periodos temporales de comparación; 4) calidad de vida en los trasplantados y variables que la predicen: adherencia terapéutica, hospitalización, apoyo familiar, expectativas hacia el trasplante y etiología del trasplante; y 5) repercusiones psicológicas del trasplante de órganos en los familiares, teniendo en cuenta la influencia que ejerce el apoyo social sobre la salud mental de estos familiares.

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    ABSTRACT: Background Patients with chronic liver disease frequently suffer from malnutrition, together with a decline in their health-related quality of life.This study was carried out with the aim of evaluating the nutritional status, complications of medical and surgical care, anxiety, health-related quality of life and dependence level on basic and instrumental activities of daily living in pre- and post-liver transplant patients.Methods/DesignA prospective observational study with follow-up of patients on the waiting list for liver transplants who subsequently received a transplant at the University Hospital Complex in A Coruña during the period 2012¿2014 (n¿=¿110).All the patients will be followed-up for a maximum of 6 months. For survivors, assessments will be re-evaluated at one, three and six months post- transplant.Informed consent of the patient and ethical review board approval was obtained (Code: 2010/081 and 2010/082)The following variables will be studied: socio-demographic data, reason for the transplant, comorbidity (Charlson Score), analytical parameters, time on transplant waiting list and post-transplant complications. A trained nurse will evaluate the following for each patient: nutritional indices, anthropometric variables and handgrip strength. Validated questionnaires will be used to determine the patients¿ nutritional status (Subjective Global Assessment), anxiety (STAI questionnaire), Health-Related Quality of Life (LDQoL 1.0 questionnaire), dependence (Barthel Index and Lawton-Brody Scale), nursing diagnoses (NANDA) and post-transplant quality indicators.Multiple linear/logistic regression models will be used to identify variables associated with the events of interest. Changes in nutritional status, quality of life and dependence over time will be analysed with linear mixed-effects regression models.Actuarial survival analysis using Kaplan-Meier curves, Cox regression and competitive risk will be performedConcordance between the different scores that assess nutritional status and interobserver agreement regarding nursing diagnoses will be studied using the statistical Kappa index and Bland Altman method.DiscussionThe risk of malnutrition can be considered as a possible prognostic factor in transplant outcomes, associated with anxiety, health-related quality of life and dependence.For this reason we consider interesting to perform a prospective follow-up study of patients who require a transplant to survive, studying their nutritional status and health-related quality of life.
    BMC Gastroenterology 01/2015; 15(1):6. DOI:10.1186/s12876-015-0232-3 · 2.11 Impact Factor
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    ABSTRACT: The aim of this investigation is to analyze the psychological differences of patients and their relatives according to the formers' post-transplantation anxiety. We used two groups of participants: transplant patients (n = 166) and close relatives (n = 166). Four questionnaires were applied: a Psychological Survey (to both groups), the Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire (to the transplant patients), and the Leeds Scales for the Self-Assessment of Anxiety and Depression (to the relatives). Participants were assessed twice: post-Intensive Care Unit (ICU; when patients were moved from the ICU to the Transplantation Unit) and post-hospital (one year after transplant). Results showed that high anxiety in patients just after organ transplant was related to an increase of anxiety and depression symptoms both in patients and relatives one year after transplant; it was also related to a decrease in the quality of life of these patients.
    The Spanish Journal of Psychology 05/2008; 11(1):250-8. DOI:10.1017/S1138741600004285 · 0.74 Impact Factor
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    ABSTRACT: In patients awaiting a transplant, the help received from friends and/or family members is considered to be an important factor in the transplantation process. Our objective was to determine the level of social/family support for patients on the liver transplant waiting list and to determine the relationship between clinical psychopathology and the level of social/family support. The study population consisted of 70 patients on the liver transplant waiting list. We used the following instruments: (1) Medical Outcomes Study-Social Support Survey (MOS) Questionnaire. For size of the social network, four support dimensions and a global support index for emotional support, material/instrumental support, leisure/free time activities, and love/care; (2) Family Apgar Questionnaire for personal perception of family function; (3) SA-45 questionnaire of psychopathologic symptoms for somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The MOS showed that the mean size of the social network of these patients was 12 people. In these patients, social/family support was nonfunctional in 20% of the cases. By dimensions, the patients had the following percentage of nonfunctional support: 24% in emotional support; 10% material/instrumental support; 23% social relations of leisure/free-time activities; and 11% compassionate love/care support. The patients with nonfunctional support had the following associated psychopathologic symptoms (SA-45): depression (79% vs 39%; P = .008), anxiety (86% vs 46%; P = .008), hostility (43% vs 12%; P = .009), and psychoticism (14% vs 2%; P = .039) compared to functional patients. The Family Apgar showed that 27% of patients perceived a family dysfunction. These patients had greater interpersonal sensitivity-type emotional symptoms (32% vs 8%; P = .012), depression (79% vs 35%; P = .001), anxiety (79% vs 45%; P = .011), and hostility (42% vs 10%; P = .002) compared to normally functioning patients. Nearly a quarter of patients on the liver transplant waiting list have social/family support that is nonfunctional, which leads to greater emotional psychopathologic symptoms that would need to be treated.
    Transplantation Proceedings 04/2011; 43(3):701-4. DOI:10.1016/j.transproceed.2011.01.095 · 0.95 Impact Factor

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