Psychosocial factors, physical symptoms and physical function after lung transplantation

2.50
Hdl Handle:
http://hdl.handle.net/10755/163606
Category:
Abstract
Type:
Presentation
Title:
Psychosocial factors, physical symptoms and physical function after lung transplantation
Author(s):
Dabbs, Annette; Dew, Mary Amanda; Stiley, Carol; Manzetti, Jan; Zullo, Thomas
Author Details:
Annette De Vito Dabbs, PhD, RN, Assistant Professor, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: ajdst42@pitt.edu; Mary Amanda Dew; Carol Stiley; Jan Manzetti; Thomas Zullo
Abstract:
Background: Lung transplantation is performed to prolong survival, relieve symptoms, and improve physical function. The majority of lung transplant recipients (LTR) experience overall improvements but are faced with the specter of new symptoms due to complications that invariably develop. Although LTR report significantly better mental health than transplant candidates, anxiety and depression exceed normative values. Evidence also supports associations between pre-transplant psychiatric history and posttransplant psychiatric disorders, and between mental health and physical functioning after lung transplant. Differences due to gender and type of procedure (lung versus heart/lung) have also been reported. Aims: 1. Describe levels of psychosocial factors, physical symptoms, physical function 2. Determine whether there were differences due to type of procedure (lung versus heart-lung) and gender 3. Examine the relationships between psychosocial factors, physical symptoms and physical function 4. Determine whether psychosocial factors rendered LTR vulnerable to increased physical symptoms or impaired physical function. Methods: Secondary analysis of data for 36 lung and 14 heart/lung transplant recipients, guided by the theory of unpleasant symptoms (TOUS). Measures: family psychiatric history (Renard Diagnostic Interview Form); personal history of psychiatric disorders (Structured Clinical Interview for DSM III-I); post-transplant psychological distress (anxiety and depression subscales of Symptom Checklist 90-R); self-esteem (Rosenberg Self-Esteem Scale); mastery (Sense of Mastery Scale); coping strategies (Moos' Coping Checklist); physical symptoms (Simmons' Checklist & SCL-90 somatic scale); physical functional impairment (Sickness Impact Profile physical dimension). Results: Percentage of Cohort with Each Characteristic: (+) Family psych history (31%); (+) Personal psych history (47%); Elevated anxiety symptoms (39%); High depressive sx. (36%); Low self-esteem (46%); Low mastery (52%); Low active cognitive coping (39%); Low active behavioral coping (28%); High avoidance coping (26%). LTR with personal psychiatric histories reported higher distress levels of anxiety (r =.38) and depression (r =.38) and these distress levels correlated with physical symptoms (r = .54- .65) and physical impairment (r = .49-.51). Anxiety and depression levels exceeded nonpatient norms. Large proportions of the cohort reported low levels of self-esteem and mastery, and lower mastery was associated with higher physical impairment (r = .36). Only a minority of LTR used negative coping strategies, and no correlates of coping were identified. Mean physical impairment scores (16.+/-23.8) were consistent with scores reported by pulmonary patient populations, including transplant candidates, but were higher than reported in other studies of LTR beyond 3 months post-transplant. Mean physical symptom scores (16.8+5) were higher, but frequently endorsed individual items were comparable, to those reported in other LTR studies using similar symptom tools. Psychosocial factors explained a significant proportion of the variance in physical symptoms (R= .646) and impaired physical function (R= .545). Lung procedures were associated with higher levels of depression, rehospitalizations, physical symptoms and impaired function (p< .05) than heart/lung. No gender differences were found. Conclusions: Psychological distress, symptoms and physical impairment are common in LTR. LTR experiencing psychological distress in the areas of anxiety and depression were more likely to have higher physical symptom and impairment levels. As the TOUS predicted, relationships exist between psychosocial factors and physical symptom levels, and between physical symptoms and physical functional impairment (r = .60). Implications: The direction of influence between correlates need to be examined. Other factors that may influence physical symptoms and physical impairment need to be explored. Interventions to reduce psychological distress need to be developed.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePsychosocial factors, physical symptoms and physical function after lung transplantationen_GB
dc.contributor.authorDabbs, Annetteen_US
dc.contributor.authorDew, Mary Amandaen_US
dc.contributor.authorStiley, Carolen_US
dc.contributor.authorManzetti, Janen_US
dc.contributor.authorZullo, Thomasen_US
dc.author.detailsAnnette De Vito Dabbs, PhD, RN, Assistant Professor, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: ajdst42@pitt.edu; Mary Amanda Dew; Carol Stiley; Jan Manzetti; Thomas Zulloen_US
dc.identifier.urihttp://hdl.handle.net/10755/163606-
dc.description.abstractBackground: Lung transplantation is performed to prolong survival, relieve symptoms, and improve physical function. The majority of lung transplant recipients (LTR) experience overall improvements but are faced with the specter of new symptoms due to complications that invariably develop. Although LTR report significantly better mental health than transplant candidates, anxiety and depression exceed normative values. Evidence also supports associations between pre-transplant psychiatric history and posttransplant psychiatric disorders, and between mental health and physical functioning after lung transplant. Differences due to gender and type of procedure (lung versus heart/lung) have also been reported. Aims: 1. Describe levels of psychosocial factors, physical symptoms, physical function 2. Determine whether there were differences due to type of procedure (lung versus heart-lung) and gender 3. Examine the relationships between psychosocial factors, physical symptoms and physical function 4. Determine whether psychosocial factors rendered LTR vulnerable to increased physical symptoms or impaired physical function. Methods: Secondary analysis of data for 36 lung and 14 heart/lung transplant recipients, guided by the theory of unpleasant symptoms (TOUS). Measures: family psychiatric history (Renard Diagnostic Interview Form); personal history of psychiatric disorders (Structured Clinical Interview for DSM III-I); post-transplant psychological distress (anxiety and depression subscales of Symptom Checklist 90-R); self-esteem (Rosenberg Self-Esteem Scale); mastery (Sense of Mastery Scale); coping strategies (Moos' Coping Checklist); physical symptoms (Simmons' Checklist & SCL-90 somatic scale); physical functional impairment (Sickness Impact Profile physical dimension). Results: Percentage of Cohort with Each Characteristic: (+) Family psych history (31%); (+) Personal psych history (47%); Elevated anxiety symptoms (39%); High depressive sx. (36%); Low self-esteem (46%); Low mastery (52%); Low active cognitive coping (39%); Low active behavioral coping (28%); High avoidance coping (26%). LTR with personal psychiatric histories reported higher distress levels of anxiety (r =.38) and depression (r =.38) and these distress levels correlated with physical symptoms (r = .54- .65) and physical impairment (r = .49-.51). Anxiety and depression levels exceeded nonpatient norms. Large proportions of the cohort reported low levels of self-esteem and mastery, and lower mastery was associated with higher physical impairment (r = .36). Only a minority of LTR used negative coping strategies, and no correlates of coping were identified. Mean physical impairment scores (16.+/-23.8) were consistent with scores reported by pulmonary patient populations, including transplant candidates, but were higher than reported in other studies of LTR beyond 3 months post-transplant. Mean physical symptom scores (16.8+5) were higher, but frequently endorsed individual items were comparable, to those reported in other LTR studies using similar symptom tools. Psychosocial factors explained a significant proportion of the variance in physical symptoms (R= .646) and impaired physical function (R= .545). Lung procedures were associated with higher levels of depression, rehospitalizations, physical symptoms and impaired function (p< .05) than heart/lung. No gender differences were found. Conclusions: Psychological distress, symptoms and physical impairment are common in LTR. LTR experiencing psychological distress in the areas of anxiety and depression were more likely to have higher physical symptom and impairment levels. As the TOUS predicted, relationships exist between psychosocial factors and physical symptom levels, and between physical symptoms and physical functional impairment (r = .60). Implications: The direction of influence between correlates need to be examined. Other factors that may influence physical symptoms and physical impairment need to be explored. Interventions to reduce psychological distress need to be developed.en_GB
dc.date.available2011-10-27T11:10:31Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:10:31Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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