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Kathleen L Grady,
Edward Wang,
Connie White-Williams,
David C Naftel, Susan Myers,
James K Kirklin,
Bruce Rybarczyk,
James B Young,
Dave Pelegrin,
Jon Kobashigawa,
Robert Higgins,
Alain Heroux
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ABSTRACT: Heart transplant-related stressors and coping are related to poor outcomes early after transplant. The purposes of our study were to (1) identify the most frequent and bothersome stressors and most used and effective coping strategies and (2) compare the most frequent and bothersome stresses and most used and effective coping styles between patients at 5 and 10 years after heart transplantation. We also examined differences in coping styles by patient characteristics and factors associated with frequency and intensity of stress at 5 and 10 years after heart transplantation.
This report is a secondary analysis of data from a prospective, multisite study of quality of life outcomes. Data are from separate cohorts of 199 patients at 5 years after transplant and 98 patients at 10 years. Patients completed the Heart Transplant Stressor Scale and Jalowiec Coping Scale. Statistical analyses included frequencies, measures of central tendency, t-tests, chi-square, and generalized linear models.
At 5 and 10 years after heart transplantation, the most bothersome stressors were regarding work, school, and financial issues. Patients who were 10 years after transplant reported less stress, similar stress intensity, and less use and perceived effectiveness of negative coping than patients who were 5 years after transplant. Long-term after transplant, demographic characteristics, psychologic problems, negative coping, and clinical factors were related to stress frequency and/or intensity.
Heart transplant-related stress occurs long-term after surgery. Types of transplant-related stress and factors related to stress confirm the importance of ongoing psychologic and clinical support after heart transplantation.
The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 04/2013; 32(4):437-46. · 3.54 Impact Factor
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ABSTRACT: BACKGROUND: Despite the fact that social support has been found to be important to cardiovascular health, there is a paucity of information regarding the relationship between social support and outcomes long term after heart transplantation (HT). The purposes of this study were to examine demographic and psychosocial characteristics and their relationship to social support after HT and to identify whether socio-demographic variables are predictors of satisfaction with social support post-HT. METHODS: Data were collected from 555 HT patients (pts) (78% men, 88% white, mean age = 53.8 yr at time of transplant) at four US medical centers using the following instruments: Social Support Index, QOL Index, HT Stressor Scale, Jalowiec Coping Scale, Sickness Impact Profile, Cardiac Depression Scale, and medical records review. Statistical analyses included t-tests, correlations, and linear and multivariate regression. RESULTS: There were no associations between education and ethnicity and perception of social support at five and 10 yr after HT. Married and older pts reported higher satisfaction with social support after HT. Being married and having higher education were predictors of better overall satisfaction with social support at 10 yr post-heart transplantation. CONCLUSIONS: Knowledge of relationships between socio-demographic factors and social support may assist clinicians to address social support needs and resources long term after HT.
Clinical Transplantation 12/2012; · 1.67 Impact Factor
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ABSTRACT: BACKGROUND:: Despite the fact that social support has been found to be important to cardiovascular health, there is a paucity of information regarding the relationship between social support and outcomes long-term after heart transplantation (HT). OBJECTIVES:: Therefore, the purposes of our retrospective analyses of a prospective, longitudinal study were to examine (1) the relationship between satisfaction with social support and post-HT health-related quality of life (HRQOL) and survival and (2) whether 2 types of social support (emotional and tangible) were predictors of survival and HRQOL. METHODS:: Data were collected from 555 HT patients over a 5-year period (78% male, 88% white; mean age, 53.8 years at time of transplantation) at 4 US medical centers using the following instruments: Social Support Index, Quality of Life Index, Heart Transplant Stressor Scale, Jalowiec Coping Scale, and medical records review. Statistical analyses included t tests, correlations, Kaplan-Meier survival actuarials, and linear and multivariable regression. RESULTS:: Patients were very satisfied with overall social support from 5 to 10 years after HT (0 = very satisfied, 1 = very dissatisfied), which was stable across time (P = .74). Satisfaction with emotional social support (P = .53) and tangible social support (P = .61) also remained stable over time. When stratified into low, medium, and high levels of satisfaction, satisfaction with social support was not related to survival (P = .24). At 5 years, overall satisfaction with social support was a predictor of HRQOL (r = 0.59, P < .0001), and satisfaction with emotional social support was a predictor of HRQOL at 10 years after HT (r = 0.66, P < .0001). CONCLUSIONS:: Patients were very satisfied over time with emotional and tangible social support. While social support explained quality of life outcomes, it did not predict survival. Knowledge of relationships among social support, stress, and outcomes may assist clinicians to address social support needs and resources long-term after HT.
The Journal of cardiovascular nursing 05/2012; · 1.43 Impact Factor
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Kathleen L Grady,
Edward Wang,
Robert Higgins,
Alain Heroux,
Bruce Rybarczyk,
James B Young,
Dave Pelegrin,
Jennifer Czerr,
Jon Kobashigawa,
Julie Chait,
David C Naftel,
Connie White Williams, Susan Myers,
James K Kirklin
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ABSTRACT: Patterns of symptom frequency and distress have not been examined long-term after heart transplantation, nor have predictors of long-term symptom frequency and distress. This report identified the most commonly reported and distressful symptoms long-term after transplantation, described patterns of symptom frequency and distress over time, and examined predictors of symptom frequency and distress at 5 and 10 years after heart transplantation.
The sample included 555 participants from a prospective, multisite, longitudinal study of quality of life outcomes. Patients were 78% male, 88% white, 79% married, and mean age of 54 years at time of heart transplantation. Data were collected using patient self-report and medical records review. Statistical analyses included descriptive statistics, Pearson correlations, t-tests, and generalized linear models.
Significant predictors of lower symptom frequency after heart transplantation were not having psychological problems and not having cardiac allograft vasculopathy at 5 years, and not having psychological problems and not having infection at 10 years. Significant predictors of less symptom distress were having more than a high school education, having no psychological problems, and having gout at 5 years, and being married at 10 years.
Symptom frequency is low and symptom distress is moderate long-term after heart transplantation. Significant relationships exist between both demographic and clinical variables and symptom frequency and distress. Identification of the most common and bothersome symptoms after heart transplantation provides clinicians with important information from which to develop a plan of care.
The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 09/2009; 28(8):759-68. · 3.54 Impact Factor
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Kathleen L Grady,
David C Naftel,
James B Young,
Dave Pelegrin,
Jennifer Czerr,
Robert Higgins,
Alain Heroux,
Bruce Rybarczyk,
Mary McLeod,
Jon Kobashigawa,
Julie Chait,
Connie White-Williams, Susan Myers,
James K Kirklin
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ABSTRACT: Researchers have not examined relationships between perception of physical functional disability and demographic, clinical, and psychological variables at 5 to 10 years after heart transplantation. Therefore, the purposes of this study were to describe physical functional disability over time and identify predictors of physical functional disability from 5 to 10 years after heart transplantation.
The study enrolled 555 patients who were between 5 and 10 years post-heart transplant (age, 54 +/- 9 years; 78% male, 88% white, 79% married). Patients completed 6 instruments that measure physical functional disability and factors that may impact physical functional disability. Statistical analyses included calculation of frequencies, means +/- standard deviation (plotted over time), Pearson correlation coefficients, and multiple regression coupled with repeated measures.
Between 5 and 10 years after heart transplantation, physical functional disability was low, and 34% to 45% of patients reported having no functional disability. More physical functional disability was associated with having more symptoms, having depression/mood/negative affect and lower use of negative coping strategies, having more comorbidities and more specific comorbidities (e.g., more orthopedic problems and diabetes); higher New York Heart Association functional class; having more acute rejection, infection, or cardiac allograft vasculopathy; being female, older, less educated, and unemployed; higher body mass index; and more hospital readmissions (explaining 46% of variance [F = 84.75, p < 0.0001]).
Demographic, clinical, and psychological factors were significantly related to physical functional disability. Knowledge of these factors provides the basis for development of therapeutic plans of care.
The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 11/2007; 26(11):1182-91. · 3.54 Impact Factor
