The correlation of patientsʼ anxiety after a liver or kidney transplantation with functional and self-reported work ability

Abstract

Organ transplantation has become the treatment of choice for end-stage organ failure, including renal and liver failure. The benefits of patient employment after transplantation are numerous, but factors determining the ability to work among these patients are not clearly defined. The growing interest in these factors has strong practical implications for organizations creating vocational rehabilitation programs. Given the interconnection between psychological and physical functioning in patients after transplantation, the present study examined the impact of anxiety on vocational rehabilitation and its relationship with functional tests. A total of 100 patients after liver or kidney transplantation underwent functional tests, including the 6-minute walking test and 30-second chair stand test (30”CST), and psychological tests, specifically the Inventory of Physical Activity Objectives, Work Ability Index, and State-Train Anxiety Inventory. Working ability was affected by psychological factors. State and trait anxiety exhibited inverse relationships with subjective readiness to occupational activity ( P < .001, r = -.59 and P < .001, r = -.56, respectively). The level of anxiety was negatively related to the results of the 30”CST. State-Train Anxiety Inventory, State Anxiety subscale and State-Train Anxiety Inventory, State-Trait Anxiety subscale vs 30”CST: P < .001, r = -.43 P < .001, r = -.44). Thus, state and trait anxiety influence perceived work ability and partially functional status. These observations may indicate the potential benefits of including psychologists in interdisciplinary teams for physical and especially vocational rehabilitation of patients after liver or kidney transplantation.

Physical Activity Behaviour in Solid Organ Transplant Recipients: Proposal of Theory-Driven Physical Activity Interventions

“…The majority of transplant recipients are men (65%) [93], while the age distribution amongst patients receiving a transplant shows that 4% is 0-14 years, 44% is 16-55 years, 30% is 56-64 years, and 22% is >65 years old (https://www.eurotransplant.org/statistics/ annual-report/, accessed on 10 January 2022). Some studies have indicated that older [11,28] and female [8] transplant recipients tend to be less physically active, but, interestingly, reported no significant differences in physical activity levels [8,76] or barriers and motivators [11,76] between the different organ transplant recipient groups. One study documented that lung and heart transplant recipients participated more in high levels of physical activity [72], while another study did not identify such differences [8].…”

“…The barriers and motivators were classified according to COM-B and TDF (Table 4) and subsequently embedded and discussed below according to the context dimension of CICI. The identified barriers and motivators were related to participation in physical activity and/or exercise [8,11,54,[69][70][71][72][73][74][75][76][77][78][79], exercise-based rehabilitation [80][81][82][83], or participation in the World Transplant Games [84]. The terms physical activity and exercise were often used interchangeably, making it impossible to make a clear distinction between these variables.…”

“…Five studies (six records) focused solely on kidney transplant recipients (n = 741) [69,70,74,75,79,82], one study on liver transplant recipients (n = 13) [71], one study on heart transplant recipients (n = 8) [83], one study on lung transplant recipients (n = 111) [73], and one study did not specify the transplant population (n = 13) [54]. Eight independent studies (nine records) evaluated barriers and motivators in cohorts of various organ transplant recipients, i.e., 531 kidney transplant recipients, 250 liver transplant recipients, 148 lung transplant recipients, 114 heart transplant recipients, and four multi-organ transplant recipients [8,11,72,[76][77][78]80,81,84]. Based on limited literature data, there are no differences in barriers and motivators between different solid organ transplant groups [11,76].…”

“…Eight independent studies (nine records) evaluated barriers and motivators in cohorts of various organ transplant recipients, i.e., 531 kidney transplant recipients, 250 liver transplant recipients, 148 lung transplant recipients, 114 heart transplant recipients, and four multi-organ transplant recipients [8,11,72,[76][77][78]80,81,84]. Based on limited literature data, there are no differences in barriers and motivators between different solid organ transplant groups [11,76]. Various methods were used, with the majority of studies applying semi-structured interviews [11,70,71,74,79,81,83] and others using web-based questionnaires [72,73,80,84] or standardized questionnaires, such as Barriers and Motivators Questionnaire [8,69], the Exercise Benefits/Barriers Scale [82], Tampa Score of Kinesophobia [75], Inventory of Physical Activity Objectives questionnaire [76], Behavioural Regulation in Exercise Questionnaire-2 [78], Perceived Physical Activity Scale (sub-scale of the Physical Self-Efficacy Scale) [75], or Exercise Self-Efficacy Scale [8].…”

“…Kidney transplant recipients comprised the majority of included individuals (n = 1272; 66%), followed by liver (n = 263; 14%), lung (n = 259; 13%), and heart (n = 122; 6%) transplant recipients. A few studies that included mixed groups of transplant patients reported that no differences in barriers and motivators were apparent between different solid organ transplant groups [11,76]. Below we present a set of selected physical activity intervention strategies we consider most promising to promote patients' long-term physical activity behaviour.…”