Predictors of post‐traumatic psychological growth in the late years after lung transplantation

Abstract

Background Although lung transplantation improves quality of life, most psychosocial research focuses on adverse psychological and social functioning outcomes. Positive effects, particularly in the late-term years as physical morbidities increase, have received little attention. We provide the first data on a psychological benefit—posttraumatic growth (PTG)—and we focused on long-term (>5 year) survivors. Methods Among 178 patients from a prospective study of mental health during the first two years posttransplant, we re-contacted survivors 6–11 years posttransplant. We assessed PTG (i.e., positive psychological change resulting from the transplant) and examined its relationship to other patient characteristics with multivariable regression analyses. Results 64 patients (86% of survivors) were assessed (M=8.1 years posttransplant, SD=1.2). Mean PTG exceeded the scale’s midpoint (M=38.6, SD=10.0; scale midpoint=25). Recipients experiencing greater PTG were female (p=.022), less educated (p=.014), and had a history of posttransplant panic disorder (p=.005), greater friend support (p=.048), and better perceived health (p=.032). Neither other pre- or posttransplant mood and anxiety disorders nor transplant-related morbidities (acute rejection, bronchiolitis obliterans syndrome) predicted PTG. Conclusions PTG exceeded levels observed in other chronic disease populations, suggesting that lung transplantation may uniquely foster positive psychological change in long-term survivors. PTG occurs despite physical and psychiatric morbidities. Whether PTG promotes other positive posttransplant psychosocial outcomes deserves attention.

Post-traumatic growth and its relationship to quality of life up to 9 years after liver transplantation: a cross-sectional study in Spain

“…This may be associated with a sense of gratitude towards the deceased donor and the medical team, and a feeling of personal responsibility for justifying all their efforts, which may in turn mobilise a large amount of energy. 6 28 …”

“…Basically post-traumatic growth can be regarded as a protective factor 12 13 that enables patients to reframe threats into challenges, thereby strengthening their psychological well-being. 14 15 Previous studies have found high levels of post-traumatic growth after lung transplantation, 6 which were even higher than those observed in patients suffering from chronic heart disease, cancer or HIV. High levels of post-traumatic growth have also been found after haematopoietic stem cell transplantation (HSCT).…”

“… 1 The best medical option is liver transplantation, which provides longer survival and better quality of life. 2–4 However, even after liver transplantation, quality of life often remains below levels found in the general population, 5 because acute and chronic graft rejection, recurrence of liver disease or secondary effects of immunosuppressants are very stressful complications for patients and their families, 6–8 and may lead to the development of psychological disorders. 9–11 …”

“…Even though post-traumatic growth is thought to contribute to well-being and quality of life after transplantation, not all previous studies have found a significant positive association between these two variables. For example, Fox et al 6 found in a sample of 64 lung transplant recipients a minimal association between post-traumatic growth and physical functional quality of life. This result illustrates that post-traumatic growth is not related per se to higher quality of life.…”

Updates in Psychosomatic Medicine: 2014

“…The articles were Updates in Psychosomatic Medicine related to 15 subspecialties: cardiac psychiatry, [4][5][6][7][8][9] collaborative care/integrated behavioral health, 10,11 emergency psychiatry, 12,13 HIV psychiatry, [14][15][16][17][18][19][20] neuropsychiatry, 21-31 pediatric psychosomatic medicine, 32-36 psychodermatology, [37][38][39][40][41][42][43][44][45] psychonephrology, 46-55 psycho-oncology and palliative care, [56][57][58][59][60][61][62][63][64] serious mental illness, [65][66][67][68][69][70][71][72] somatic symptom disorders, 73 suicide, 74-78 transplant psychiatry, [79][80][81][82][83][84]…”