Hi guys,

Found another review paper on the psychosocial experience in organ transplant patients. It talked about a lot of the psychosocial problems patients and families may face. Here’s what I gathered for lung patients.

It is broken down into 4 stages in the continuum of care:

1)      Pretransplant psychosocial problems:

-          Family forced to make adjustments

-          Changing roles

-          Anxiety about the future, losses of body integrity, comfort, independence, autonomy, privacy and control

-          Fear

-          Loss of income

-          Threats to economic wellbeing

2)      Prevevaluation psychosocial problems:

-          Worried about whether or not they will be eligible for transplant

-          Sense of relief after completing the evaluation

3)      Post-evaluation/preoperative psychosocial problems:

-          Burden of relocation

-          Possibility for hospitalization for pulmonary insufficiency and infection (physical confinement due to progressive disability)

-          Anxiety (wait time for transplant can lead to hopelessness and loss of control)

-          Guilt (someone has to die for them to receive the transplant)

4)       Post-operative/discharged psychosocial problems:

-          Unacknowledged anxiety on leaving the safety of the hospital

-          Estrangement from the community and family (unrealistic expectations from family)

-          Sexual dysfunction (medication-induced, body image issue)

-          Employment (early retirement, modification to work, unemployment)

The paper also identified 3 major psychological problems:

1)      Transient adjustment disorder

2)      Major depressive disorder

3)      PTSD

Psychosocial predictors of these problems are:  

-          History of psychiatric disorder

-          Low caregiver support

-          Low sense of mastery in the first 2 month post-transplant

-          Poor self-esteem

-          Use of avoidance coping strategies

-          Employment status

-          Caregiver’s health

I know we have settled on the e-support for lung patients from the East Coast. Maybe these are some of the issues we can look into. I think the first 2 stages are a good place to start. 

Engle, D. (2001). Psychosocial Aspects of the Organ Transplant Experience: What Has Been Established and What We Need for the Furture. Journal of Clinical Psychology. 57(4), 521-549. 

-Chao