Stress and coping in caregivers of patients awaiting solid organ transplantation

Abstract

Caregivers for patients undergoing solid organ transplantation play an essential role in the process of transplantation. However, little is known about stress and coping among these caregivers. Six hundred and twenty-one primary caregivers of potential candidates for lung (n = 317), liver (n = 147), heart (n = 115), and/or kidney (n = 42) transplantation completed a psychometric test battery at the time of the candidate’s initial pre-transplant psychosocial evaluation. Caregivers were generally well adjusted, with only 17% exhibiting clinical symptoms of depression (Beck Depression Inventory-II score > 13) and 13% reporting clinical levels of anxiety (State Trait Anxiety Inventory score >48). Greater caregiver burden and negative coping styles were associated with higher levels of depression. Greater objective burden and avoidant coping were associated with higher levels of anxiety. Caregivers evidenced a high degree of socially desirable (i.e., defensive) responding, which may reflect a deliberate effort to minimize fears or worries so as to not jeopardize patients’ listing status.

Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

“…Hence, caregiver burden may be high. 53,54 Parents of children who have had heart and other solidorgan transplantations report that these stressors can be mediated by support anticipation from health professionals. 55 …”

Coping strategies after heart transplantation: psychological implications

“…This preparation allows the patient a moment to talk about the transplant, so that he becomes aware of his fantasies and feelings, as well as the personal way of addressing the situation, a fact that enables a change of behavior and favors the adoption of coping modes more active and adapted to the situation, such as the confrontation focused on solving the problem and the search for social support [22]. These coping strategies are fundamental to the survival, since they influence the behavior of adherence to treatment [9,15].…”

Impacto Psicossocial De Pacientes Candidatos a Transplante De Fígado

“…Cada pessoa reage de diferente maneira diante do adoecer, sendo o mais comum é desejar manter distância da realidade de possibilidade de morte. Num momento em que relacionamentos seriam extremadamente benéficos para a resolução de uma crise de vida e para o funcionamento emocional da família, os efeitos conjuntos dos processos sociais, familiares e individuais tendem a deixar a família menos capaz de lidar com o estresse 9 . A doença grave rompe o equilíbrio familiar.…”

“…A doença grave rompe o equilíbrio familiar. O grau de ruptura no sistema familiar é avaliado pelos seguintes fatores: 1) o contexto social e étnico; 2) a história de perdas anteriores; 3) o momento no ciclo de vida; 4) a natureza da doença grave; 5) a posição e função da pessoa no sistema familiar e 6) a abertura do sistema familiar 7,9 .…”

“…Porém, a experiência de doença crônica, somada à situação de transplante, pode produzir sentimento de caos e desorganizar o "mundo" do paciente e da família, que é forçada a fazer ajustes 7,9 . A rotina diária muda com visitas constantes ao médico, administração de medicações, exames, internações hospitalares, requerendo uma demanda adicional de toda família [9][10][11] . Todos estes fatores podem acarretar prejuízos para o paciente e mudanças significativas na vida social desses enfermos, com repercussões emocionais para pais, mães e irmãos e implicações para as relações e para a dinâmica familiar 8 -10 .…”