Impact of psychosocial status on liver transplant process

Annals of Hepatology, Год журнала: 2019, Номер 18(6), С. 804 - 809

Опубликована: Авг. 20, 2019

Liver transplant candidates and recipients are at high risk of psychological distress. Social, psychiatric patterns seem to influence morbidity mortality patients before after transplant. An accurate organ allocation is mandatory guarantee an optimal graft recipient survival. In this context, the pre-transplant social, selection potential essential for excluding major illness estimating patient compliance. Depression one most studied conditions in field transplantation. Notably, ineffectively treated depression period has been associated a worst long-term After transplant, personalized intervention might favor recovery process, improvement quality life immunosuppressant adherence. Active coping strategy represents encouraging ways positively clinical course transplanted patients. conclusion, multidisciplinary team should act three directions: prevention mood distress, early diagnosis effective treatment. coping, social support approach improve outcome

Язык: Английский

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Active coping, resilience, post-traumatic growth, and psychiatric symptoms among early and late liver transplant survivors

Liver Transplantation, Год журнала: 2023, Номер 29(3), С. 290 - 306

Опубликована: Фев. 17, 2023

Understanding survivorship experiences at different stages postliver transplantation (poat-LT) is essential to improving care. Patient-reported concepts including coping, resilience, post-traumatic growth (PTG), and anxiety/depression, have been implicated as important predictors of quality life health behaviors after LT. We aimed descriptively characterize these post-LT stages. This cross-sectional study featured self-reported surveys measuring sociodemographic, clinical characteristics, patient-reported PTG, anxiety, depression. Survivorship periods were categorized early (1 y or below), mid (1–5 y), late (5–10 advanced (10 above). Univariable multivariable logistic linear regression modeling examined factors associated with concepts. Among 191 adult LT survivors, the median stage was 7.7 years (interquartile range: 3.1–14.4) age 63 (range: 28–83); most male (64.2%) Caucasian (84.0%). High PTG more prevalent in period (85.0%) than (15.2%). trait resilience only reported by 33% survivors higher income. Lower seen among patients longer hospitalization stays About 25% had clinically significant anxiety depression, which frequent females pre-LT mental disorders. In analysis, lower active coping included ≥65 years, non-Caucasian race, levels education, nonviral liver disease. a heterogeneous cohort there variation depression Factors positive psychological traits identified. determinants has implications for how we should monitor support survivors.

Язык: Английский

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Comorbid psychiatric disorders and long-term survival after liver transplantation in transplant facilities with a psychiatric consultation-liaison team: a multicenter retrospective study

BMC Gastroenterology, Год журнала: 2023, Номер 23(1)

Опубликована: Апрель 5, 2023

Abstract Objective Comorbid psychiatric disorders negatively affect the survival rate of patients with some physical disorders. In liver transplant recipients, various have been identified as worsening prognosis. However, little is known about how presence any comorbid (overall) recipients. this study, we examined effect overall on in Methods A total 1006 recipients who underwent transplantation between September 1997 and July 2017 across eight facilities a consultation-liaison team were consecutively. Recipients categorized into those without disorder group, diagnosis time investigated retrospectively. Results Of 294 (29.2%) had insomnia ( N = 107, 10.6%), delirium 103, 10.2%), major depressive 41, 4.1%), adjustment 19, 1.9%), anxiety 17, 1.7%), intellectual disability 11, 1.1%), autism spectrum 7, 0.7%), somatic symptom 4, 0.4%) schizophrenia 0.4%), substance use 24, 2.4%) personality 2, 0.2%). The most common was within first 3 months after (51.6%). final mortality during five periods (pretransplant, to months, 1 year, years, over years posttransplant) 16.2%, 18.8%, 39.1%, 28.6%, 16.2% respectively, there no significant differences (χ2 8.05, df p 0.09). Overall significantly associated shorter (log-rank test: 0.01, hazard ratio: 1.59 [95% confidence interval: 1.14–2.21], at endpoint [%]: 62.0 vs. 83.3). adjusting for confounding variables using Cox proportional hazards regression, Conclusion did not study.

Язык: Английский

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Early Survivorship After Liver Transplantation: A Qualitative Study Identifying Challenges in Recovery From the Patient and Caregiver Perspective

Liver Transplantation, Год журнала: 2021, Номер 28(3), С. 422 - 436

Опубликована: Сен. 16, 2021

Survivorship after liver transplantation (LT) is a novel concept providing holistic view of the arduous recovery experienced transplantation. We explored components early survivorship including physical, emotional, and psychological challenges to identify intervention targets for improving process LT recipients caregivers. A total 20 in-person interviews were conducted among adults 3 6 months LT. Trained qualitative research experts interviews, coded, analyzed transcripts relevant themes representative quotes. Early comprises overcoming (1) physical challenges, with most challenging experiences involving mobility, driving, dietary modifications, medication adherence, (2) emotional new health concerns, financial worries, body image/identity struggles, social isolation, dependency issues, concerns about never returning normal. Etiology disease informed some patients hepatocellular carcinoma expressing decisional regret or uncertainty in light their post-LT experiences. Important topics identified that framed setting expectations waitlist experiences, hospital recovery, ongoing requirements. within first involves wide array challenges. Patients caregivers what they wish had known prior strategies which can inform targeted interventions.

Язык: Английский

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Posttraumatic stress disorder prevalence in medical populations: A systematic review and meta-analysis

General Hospital Psychiatry, Год журнала: 2021, Номер 69, С. 81 - 93

Опубликована: Янв. 31, 2021

PTSD is increasingly recognized following medical traumas although highly heterogeneous. It difficult to judge which contexts have the most traumatic potential and where concentrate further research clinical attention for prevention, early detection treatment. The objective of this study was compare prevalence in different populations.A systematic review literature on conducted as well a meta-analysis with final pooled result 95% confidence intervals presented. A meta-regression used investigate impact effect modifiers (PTSD severity, age, sex, timeline) size between studies.From 3278 abstracts, authors extracted 292 studies reporting prevalence. Using clinician-administered reports, highest 24 month or longer found intraoperative awareness (18.5% [95% CI=5.1%-36.6%]) lowest epilepsy (4.5% CI=0.2%-12.6%]). In overall meta-regression, only events procedures emerged significant (p = 0.006) CONCLUSION: This provides clinicians greater associated PTSD, may assist them decision engage more frequent, earlier screening referral mental health services.

Язык: Английский

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What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model

Liver Transplantation, Год журнала: 2021, Номер 27(10), С. 1454 - 1467

Опубликована: Май 4, 2021

Survivorship is a well‐established concept in the cancer care continuum with focus on disease recurrence, quality of life, and minimization competing risks for mortality; however, survivorship has not been well studied liver transplantation (LT). We investigated what means to LT patients identified motivations coping strategies overcoming challenges after LT. A total 20 in‐depth home interviews were conducted among adults 3 6 months Interviews by trained qualitative research experts coded analyzed using an inductive approach. majority recipients (75%) themselves as survivors. Integral definition was hardship (including experiences waiting list) unique experience being given “second chance” at life. Motivations survive included new chance life (55%), family (40%), spirituality/faith (30%), fear rejection (15%). caregivers multiple cope post‐LT challenges, including relying large network community, spiritual, virtual support. These findings informed conceptual model based socioecological theory, which following variables influencing survivorship: (1) pretransplant experiences, (2) individual attributes (3) interpersonal relationships other social support, (4) community relationships, (5) large‐scale factors neighborhood financial issues. survivors, identities greatly influenced pre‐LT experiences. perspectives transplantation. sources motivation used recovery that could be targets interventions aimed improving outcomes.

Язык: Английский

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Neuropsychiatric sequelae after liver transplantation and their possible mechanism via the microbiota–gut–liver–brain axis

Biomedicine & Pharmacotherapy, Год журнала: 2023, Номер 163, С. 114855 - 114855

Опубликована: Май 8, 2023

Patients after liver transplantation are often impacted by mental and even neuropsychiatric disorders, including depression, sleep anxiety, post-traumatic stress disorder. Neuropsychiatric sequelae have an adverse impact on rehabilitation can incapacitate people, reducing their quality of life. Despite screening tools effective treatments, (NSALT) not been fully diagnosed treated. Current research suggests that NSALT may be partly related to intestinal microbial variation, but the detailed mechanism remains unclear. In this review, we describe clinical diagnostic features, prevalence, prediction, course outcome, management, treatment NSALT; also summarize mechanisms through microbiota–gut–liver–brain axis. Finally, propose improve basis adjusting gastrointestinal flora, immune inflammation or vagus nerve (VN), providing a novel strategy for prevention treatment.

Язык: Английский

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Quality of life in liver transplant recipients during the Corona virus disease 19 pandemic: A multicentre study

Liver International, Год журнала: 2022, Номер 42(7), С. 1618 - 1628

Опубликована: Март 28, 2022

Liver transplant recipients require specific clinical and psychosocial attention given their frailty. Main aim of the study was to assess quality life after liver during current pandemic.

Язык: Английский

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The effect of perceived social support on the psychosocial status of parents whose child had liver transplantation

Journal of Pediatric Nursing, Год журнала: 2022, Номер 66, С. e130 - e136

Опубликована: Май 5, 2022

Язык: Английский

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Resilience, Post-Traumatic Growth, and Transplant Effects—Gender Differences Following Liver Transplantation: A Cross-Sectional Study

Healthcare, Год журнала: 2024, Номер 13(1), С. 24 - 24

Опубликована: Дек. 26, 2024

Background/Objectives: The state of patients’ health following liver transplantation is influenced by a number factors. To provide personalized nursing care, it essential to understand the impact that transplant has had on patient’s life. primary aim this study was examine gender differences in overall effect transplantation. Methods: A cross-sectional conducted using Connor–Davidson 10 Resilience Scale, 21-item Post-Traumatic Growth Inventory, and Transplant Effects Questionnaire. Data were collected during May–July 2021, statistical analyses performed. Results: sample 174 patients who completed questionnaires included study. Of these, 24.1% women. Psychological resilience men correlated with personal strength, whereas women, associated relationships others. Significant found psychological post-traumatic growth since Additionally, levels positively significantly adherence immunosuppressive therapy transplant. However, no mediating or moderating identified. Conclusions: results valuable insights for validating improving interventions from perspective. Nursing care must incorporate perspective deepen our understanding emotional determinants ability deal them.

Язык: Английский

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