Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 142 No. 2324 (2012)

Attitudes towards transplantation and medication among 121 heart, lung, liver and kidney recipients and their spouses

  • Lutz Goetzmann
  • Urte Scholz
  • Rafaela Dux
  • Michaela Roellin
  • Annette Boehler
  • Beat Muellhaupt
  • Georg Noll
  • Rudolf P. Wüthrich
  • Richard Klaghofer
DOI
https://doi.org/10.4414/smw.2012.13595
Cite this as:
Swiss Med Wkly. 2012;142:w13595
Published
03.06.2012

Summary

QUESTIONS UNDER STUDY: A transplant represents a decisive event for patients and their caregivers. This article deals with the attitudes patients and their spouses have towards the transplantation.

METHODS: In a cross-sectional study, 121 patients and their spouses were surveyed by questionnaire after a heart, lung, liver or kidney transplant. Attitudes were assessed by means of semantic differentials. Based on the results, an ‘Attitudes towards Transplantation’ Scale was developed. Sense of coherence (SOC-13), quality of life (Sf-36), quality of the relationship (RAS), burnout (BM) and the patient’s emotional response to the transplant (TxEQ-D) were additional psychosocial variables measured in order to assess the association between the attitudes and psychosocial characteristics of transplant patients and their spouses.

RESULTS: The majority of patients and their spouses reported positive attitudes towards the transplant, including the attitudes towards medication, their perceived self and fate of being a transplant patient or spouse. Patients and spouses, however, had a negative attitude towards the transplantation in terms of stress and anxiety. Patients reported greater emotional stress from the transplant and rated their post-transplant perceived fate more negatively than their spouses. Attitudes towards the transplant were significantly associated with the sense of coherence and the quality of relationship.

CONCLUSION: The attitudes of patients and spouses to different aspects of the transplant itself and to being a transplant patient or spouse should be deliberately reconsidered and facilitated in the psychosocial counselling with regard to the comprehensibility, manageability and meaningfulness of the transplant experience as well as to potential conflicts in the partnership.

References

  1. Beilby S, Moss-Morris R, Painter L. Quality of life before and after heart, lung and liver transplantation. NZMJ. 2006;116(1171):U381.
  2. Cameron JI, Whiteside C, Katz J, Devins GM. Differences in quality of life across renal replacement therapies: a meta-analytic comparison. Am J Kidney Dis. 2000;35(4):629–37.
  3. Goetzmann L, Klaghofer R, Wagner-Huber R, Halter J, Boehler A, Muellhaupt B, et al. Quality of life and psychosocial situation before and after a lung, liver or an allergenic bone marrow transplant – results from a prospective study. Swiss Med Wkly. 2006;137(Suppl 155):115S–124S.
  4. Jofre R, López-Gómez JM, Moreno F, Sanz-Guajardo D, Valderrábano F. Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998;32(1):93–100.
  5. Karam V, Castaing D, Danet C, Delvart V, Gasquet I, Adam R, et al. Longitudinal prospective evaluation of quality of life in adult patients before and one year after liver transplantation. Liver Transpl. 2003;9(7):703–11.
  6. Krasnoff JB, Vintro AQ, Ascher NL, Bass NM, Dodd MJ, Painter PL. Objective measures of health-related quality of life over 24 months post-liver transplantation. Clin Transplant. 2005;19(1):1–9.
  7. Kugler C, Strueber M, Tegtbur U, Niedermeyer J, Haverich A. Quality of life 1 year after lung transplantation. Prog Transplant. 2004;14(4):331–6.
  8. Lindqvist R, Carlsson M, Sjödén PO. Coping strategies and health-related quality of life among partners of continuous ambulatory peritoneal dialysis, haemodialysis, and transplant patients. J Adv Nursing. 2000;31(6):1398–408.
  9. Littlefield C, Abbey S, Fiducia D, Cardella C, Greig P, Levy G. Quality of life following transplantation of the heart, liver, and lungs. Gen Hosp Psychiatry. 1996;18(6):36S–47S.
  10. Pinson CW, Feurer ID, Payne JL, Wise PE, Shockley S, Speroff, T. Health-related quality of life after different types of solid organ transplantation. Ann Surg. 2000;232(4):597–607.
  11. Leventhal H. Changing attitudes and habits to reduce risk factors in chronic disease. Am J Cardiol. 1973;31(5):571–80.
  12. Murphy CL, Sheane BJ, Cunnane G. Attitudes towards exercise in patients with chronic disease: the influence of comorbid factors on motivation and ability to exercise. Postgrad Med J. 2011;87(1024):96–100.
  13. Chandramouli S, Molyneaux V, Angus RM, Calverley PMA, Chakrabarti B. Insights into chronic obstructive pulmonary disease patient attitudes on ventilatory support. Curr Opin Pulm Med. 2011;17(2):98–102.
  14. Skumanich SA, Kintsfather DP. Promoting the organ donor card: A causal model of persuasion effects. Soc Sci Med. 1996;43(3):401–8.
  15. Radecki CM, Jaccard J. Psychological aspects of organ donation: A critical review and synthesis of individual and next-of-kin donation decisions. Health Psychology. 1997;16(2):183–95.
  16. Ryckman RM, an den Borne B, Thornton B, Gold JA. Value priorities and organ donation in young adults. J Appl Soc Psychol. 2005;35(11):2421–35.
  17. Chisholm MA, Williamson GM, Lance CE, Mulloy LL. Predicting adherence to immunosuppressant therapy: a prospective analysis of the theory of planned behaviour. Nephrol Dial Transplant. 2007;22:2339–48.
  18. Goetzmann L, Moser KS, Vetsch E, Naef R, Russi EW, Buddeberg C, Boehler A. How does psychological processing relate to compliance behaviour after lung transplantation? – a content analytical study. Psych Health Med. 2007;12(4):94–106.
  19. Stilley CS, Dew MA, Stukas AA, Switzer GE, Manzetti JD, Keenan RJ, Griffith BP. Psychological symptom levels and their correlates in lung and heart-lung transplant recipients. Psychosomatics. 1999;40(6):503–9.
  20. Shapiro PA, Williams DL, Foray AT, Gelman IS. Wukich N, Sciacca R. Psychosocial evaluation and prediction of compliance problems and morbidity after heart transplantation. Transplantation. 1995;60(12):1462–6.
  21. Goetzmann L, Klaghofer R, Wagner-Huber R, Halter J, Boehler A, Muellhaupt B, et al. Quality of life and psychosocial situation before and after a lung, liver or an allogeneic bone marrow transplant – results from a prospective study. Swiss Med. Wkly. 2006;136(17–18):281–90.
  22. Ajzen I. The theory of planned behavior. Organ Behav Hum Dec. 1991;50:179–211.
  23. Ajzen I. Nature and operation of attitudes. Annu Rev Psychol. 2001;52:27–58.
  24. Antonowsky A. Unraveling the mystery of health. How people manage stress and stay well. San Francisco: Jossey-Bass; 1987.
  25. Abel T, Kohlmann T. Der Fragebogen zum Kohärenzsinn. In Brähler E, Schumacher J, Strauss B (Eds.) Diagnostische Verfahren in der Psychotherapie (pp. 326–330). Göttingen: Hogrefe; 2002.
  26. Schumacher J, Gunzelmann T, Brähler E. Deutsche Normierung der Sense of Coherence Scale von Antonovsky. Diagnostica. 2000;46(4):208–13.
  27. Singer S, Brähler E. Die “Sense of Coherence Scale” – Testhandbuch zur deutschen Version [The sense of coherence scale – test manual of the German version]. Göttingen: Vandenhoeck & Ruprecht; 2007.
  28. Ware J. SF-36 Physical & Mental Health Summary Scales: A User’s Manual. New York: Medical Outcomes Trust; 1994.
  29. Bullinger M, Kirchberger I. SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. Göttingen: Hogrefe; 1998.
  30. Hendrick SS, Dicke A, Hendrick C. The relationship assessment scale. J Soc Pers Relat. 1998;15(1):137–42.
  31. Sander J, Böcker S. Die Deutsche Form der Relationship Assessment Scale (RAS): Eine kurze Skala zur Messung der Zufriedenheit in einer Partnerschaft [The German version of the Relationship Assessment Scale (RAS): A short scale for the assessment of satisfaction in a romantic partnership]. Diagnostica. 1993;39(1):55–62.
  32. Henrich G, Herschbach P. Questions on life satisfaction (FLZ) – A short questionnaire for assessing subjective quality of life. Europ J Psychol Assess. 2000;16(3):150–9.
  33. Pines A, Aronson E, Kafry D. Burnout: From Tedium to Personal Growth. New York: The Free Press, pp. 3–168, 202–203; 1981.
  34. Enzmann S, Kleiber D. Helfer-Leiden. Stress und Burnout in psychosozialen Berufen. Heidelberg: Asanger; 1989.
  35. Enzmann D, Schaufeli WB, Janssen P, Rozeman A. Dimensionality and validity of the Burnout Measure. J Occup Organ Psychol. 1998;71(4):331–51.
  36. Ziegelmann JP, Griva K, Hankins M, Harrison M, Davenport A, Thompson D, et al. The Transplant Effects Questionnaire (TxEQ): The development of a questionnaire for assessing the multidimensional outcome of organ transplantation – example of end stage renal disease (ESRD). Br J Health Psychol. 2002;7(4):393–408.
  37. Griva K, Ziegelmann, JP, Thompson D, Jayasena D, Davenport A, Harrison M, et al. Quality of life and emotional responses in cadaver and living related renal transplant recipients. Nephrol Dial Transplant. 2002;17(12):2204–11.
  38. Klaghofer R, Sarac N, Schwegler K, Schleuniger M, Noll G, Muellhaupt B, et al. Fragebogen zur psychischen Verarbeitung einer Organtransplantation: Deutsche Validierung des Transplant Effects Questionnaire (TxEQ) [Questionnaire on emtional response after transplantation: German validation of the Transplant Effect Questionnaire (TxEQ-D)]. Z Psychosom Med Psychother. 2008;54(2):174–88.
  39. Canning RD, Dew MA, Davidson S. Psychological distress among caregivers to heart transplant recipients. Soc Sci Med. 1996;42(4):599–608.
  40. Zoellner T, Maercker A. Posttraumatic growth in clinical psychology – a critical review and introduction of a two component model. Clin Psychol Rev. 2006;26(5):626–53.
  41. Goetzmann L, Wagner-Huber R, Andenmatten-Bärenfaller M, Günthard A, Alfare C, Buddeberg C, Boehler A. Gruppentherapie nach Lungentransplantation – erste Erfahrungen mit einer themenzentrierten “Life Management Gruppe” [Group therapy following lung transplantation – first experiences with a theme centered “life management group”] Psychother Psych Med. 2006;56(7):272–5.
  42. Krueger T, Berutto C, Aubert JD. Challenges in lung transplantation. Swiss Med Wkly. 2011;8(141):w13292. doi: 10.4414 / smw.2011.13292.
  43. Goetzmann L, Scholz U, Dux R, Roellin M, Boehler A, Muellhaupt B, et al. Life satisfaction and burnout among heart, lung, liver, and kidney transplant patients and their spouses. Swiss J Psychol. 2012; in press.
  44. Scholz U, Klaghofer R, Dux R, Roellin M, Boehler A, Muellhaupt B, et al. Predicting intentions and adherence behaviour in the context of organ transplantation: Gender differences of provided social support. J Psychosom Res. 2012. 72, 214-219. doi:10.1016/j.jpsychores.2011.10.008.

Most read articles by the same author(s)

1 2 > >>