The concept of quality of life in organ transplantation.
ABSTRACT The goal of organ transplantation is not only to ensure the survival of individuals with end-stage heart, lung, liver, kidney, pancreas, and small bowel diseases, but also to offer patients the health they enjoyed before the disease, achieving a good balance between the functional efficacy of the graft and the patient's psychological and physical integrity. Quality of life (QoL) assessments are used to evaluate the physical, psychological, and social domains of health, seen as distinct areas that are influenced by a person's experiences, beliefs, expectations, and perceptions, and QoL is emerging as a new medical indicator in transplantation medicine too.
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ABSTRACT: Organ transplant health professionals (OTHP) are challenged by more and more sophisticated caring dilemmas raised by organ transplant recipients (OTR) and their families. The purposes of this study were to explore caring dilemmas and the reliable coping strategies applied by OTHPs in Taiwan. A qualitative design was used with a purposive sample of OT surgeons and nurses. Data were collected by face-to-face in-depth interviews and analyzed by content analysis. Sixty subjects (43 females, 17 male) participated in this project. They were 16 OT surgeons and 44 nurses, including RNs (n = 29), nurse practitioners (NP, n = 6), and assistant/head nurses (n = 9). Their ages ranged from 25 to 66 (mean = 38.2) years old. Their OT careers ranged from 3 to 40 (mean = 24.7) years for OT surgeons and 0.5 to 15 (years = 4.3) years for the nursing group. Five types of coping strategies for caring dilemmas were reported: (1) developing clinical paths for complex multiple-OT cases, (2) developing OT-expert training programs for interdisciplinary team members, (3) integrating acute and long-term care teams for difficult OT cases and families, (4) holding case conferences for successful and failed cases, and (5) implementing humanistic care training programs. The findings of this research provide important coping strategies that can help empower OTHPs to care for complex multiple-OT cases with humanitarian expressions. More discussion about cultivation of interdisciplinary OT experts programs, and integration of caring resources are needed in the near future.Transplantation Proceedings 05/2014; 46(4):1022-5. · 0.95 Impact Factor
Article: Bioethical Considerations[Show abstract] [Hide abstract]
ABSTRACT: The clinical literature notes that pregnancy has become an expected benefit of solid organ transplant. Establishing “best practices” in the management of this particular transplant population requires careful consideration of the ethical dimensions, broadly speaking, of post-transplant pregnancies and these women’s lived experiences. In this article we present the current clinical and social science post-transplant pregnancy research. We specifically address the psycho-social and ethical issues surrounding pre-conception counselling and post-transplant health quality of life and mothering and suggest areas for future research.Best practice & research. Clinical obstetrics & gynaecology 08/2014; 28(8):1266-1277. · 1.87 Impact Factor
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ABSTRACT: The aim of the study was to define the positive effect of physical activity and nutrition on the health related quality of life in renal transplant patients in the first year following the surgery. Interestingly, the results showed that the quality of life evaluated by SF-36 of physically active renal transplant patients reached or even overreached the values of healthy individuals. We assessed the influence of intervention (physical activity, nutrition or both) on the health related quality of life. The health related quality of life was evaluated using standardized questionnaire KDQOL-SFTM (part of the generic questionnaire SF-36), and in the period one month before transplantation (patients filled the questionnaire retrospectively during their hospitalization in the first 14 days after the surgery) and approximately 10 months after the transplantation. There were 103 patients in this study (45 females, 58 males) of the age in the range 23–75 years with the average 54.7 years (±12 years). In the period when the patient was physically active or had special nutritive therapy (9.5 months after the renal transplantation) the quality of life evaluated using SF-36 (n = 94) statistically significantly improved in all domains except for physical activity (Wilcoxon test, p < 0.05) that was lower than the values of healthy individuals in the Czech Republic. The results did not show any statistically significant difference among the items of the life quality and type of intervention done (ANOVA, p < 0.05). Also the testing of the differences among particular types of intervention with regard to the evaluation of the quality of life did not show any statistically significant changes. There is a positive impact of physical activity on the quality of life of the renal transplant patients. It seems to be the most effective tool improving the quality of life, when physical activity is combined with nutrition therapy.Kontakt. 12/2014;