Bedarf und Inanspruchnahme psychosozialer Betreuung nach Lebertransplantation

Abstract

Studies on the need of psychosocial support after liver transplantation (LTX) are rare. At our centre we conducted a survey regarding this question in a one year period with a consecutive sample of 146 patients on average 38 month (SD = 28) after liver transplantation. An assessment of the need was estimated in self-assessment, in a rating after completion of an interview, by the estimate of the attending physicians and with the help of standardized questionnaires. 44.5 % of the patients expressed either a present need (15 %) or a need at an earlier time (29.5 %). The physicians classified 20 % as in need of psychosocial care and from the interviewer's point of view 50 % of the patients needed care. The rating correlated to r = 0.32 (physician) and r = 0.55 (interviewer) with the self-assessment. In the modified Hornheider questionnaire 18 % of the patients were classified as in need of care. In the German version of the Hospital Anxiety and Depression Scale (HADS-D) 25 % of the patients exhibit increased anxiety values and 16 % of the patients depressive symptoms. The results of the questionnaires are highly intercorrelated and correlated low (estimate of physicians) to medium high (estimate of interviewer) with the ratings of need. Grouped according to their self-assessment of need, the groups of patients differ significantly in the applied questionnaires. Patients who do not indicate any need show the lowest anxiety and depression values and report the fewest problems. The offer of psychosocial support in the survey period was utilized by 27 of the participating patients (19 %). Altogether we can estimate the current need at a certain time between 15 and 20 % and a total need after LTX up to 50 %. These results require further examination and the appropriate form of psychosocial offers for these patients should be developed in further research.

Psychosocial challenges before and after organ transplantation

“…A need for psychological care was found in up to 50% of transplant patients. 53,54 Of particular importance are educational and supportive therapy elements but also cognitive-behavioral interventions including relaxation techniques. [55][56][57] Less common methods like hypnotherapy 58 and "Quality of Life Therapy" 59 have also been utilized.…”

Psychosocial Aftercare After Organ Transplantation

“…Equally, psychological acceptance of the donor organ can present a formidable difficulty and may manifest as depressive symptoms or identity disorders. Recent studies have therefore pointed out a need for more psychosocial aftercare in transplant patients (3).…”

Inanspruchnahme und Akzeptanzvergleich eines psychoonkologischen Nachsorgeangebots bei von Brustkrebs betroffenen Frauen

“…auch [17,20,23,25]). Tendenziell steigt mit dem Grad der geforderten persönlichen Beteiligung an der psychosozialen Intervention die Psychopathologie, d. h. dass die Inanspruchnehmerinnen der psychoonkologischen Einzeltherapie im Vergleich zu den Inanspruchnehmerinnen des Patientinnenseminars und der psychoonkologischen Sprechstunde am stärksten belastet sind.…”