Academic journal article The Spanish Journal of Psychology

Psychological Differences of Patients and Relatives According to Post-Transplantation Anxiety

Academic journal article The Spanish Journal of Psychology

Psychological Differences of Patients and Relatives According to Post-Transplantation Anxiety

Article excerpt

The aim of this investigation is to analyze the psychological differences of patients and their relatives according to the formers' post-transplantation anxiety. We used two groups of participants: transplant patients (n = 166) and close relatives (n = 166). Four questionnaires were applied: a Psychological Survey (to both groups), the Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire (to the transplant patients), and the Leeds Scales for the Self-Assessment of Anxiety and Depression (to the relatives). Participants were assessed twice: post-Intensive Care Unit (ICU; when patients were moved from the ICU to the Transplantation Unit) and post-hospital (one year after transplant). Results showed that high anxiety in patients just after organ transplant was related to an increase of anxiety and depression symptoms both in patients and relatives one year after transplant; it was also related to a decrease in the quality of life of these patients.

Keywords: organ transplant, anxiety, depression, quality of life

El objetivo de esta investigación es analizar las diferencias psicológicas en pacientes y familiares en función de la ansiedad post-trasplante. Seleccionamos dos grupos: 166 trasplantados y los 166 familiares más allegados de estos pacientes. Empleamos una Encuesta Psicosocial (en ambos grupos), la Escala de Ansiedad y Depresión en Hospital y el Cuestionario de Calidad de Vida (en el grupo de trasplantados) y las Escalas de Ansiedad y Depresión de Leeds (en el grupo de familiares). La evaluación psicológica se realizó en dos fases: post-UCI (cuando a los pacientes se les daba el alta de la UCI pero continuaban ingresados en el hospital, concretamente, en la Unidad de Trasplantes) y post-hospitalaria (cuando transcurría un año del alta hospitalaria de los pacientes tras el implante). Los resultados mostraron que un nivel alto de ansiedad en los pacientes tras el trasplante, aumentaba al año la sintomatología ansiosa y depresiva de los pacientes y de sus familiares y, además, empeoraba la calidad de vida de los trasplantados.

Palabras clave: trasplante de órganos, ansiedad, depresión, calidad de vida

Organ transplant is a therapeutic alternative that offers patients more quantity and quality of life. However, it must be taken into account that not all patients attain better physical, psychological, and social well-being. For example, in an investigation carried out with liver transplant patients, it was found that 60% of the patients considered that their life had not become normalized after transplantation, mainly due to the presence of diverse physical and psychological problems: secondary effects of medication, fatigue, gastrointestinal problems, osteoporosis, and depression (Holzner et al., 2001). Along these lines, in a review by Pérez, Martín, and Galán (2005), the authors concluded that transplant patients could suffer from various psychological complications, such as: immediate post-operation delirium caused by immunosupressor medication, sexual disorders caused either by physical (the disease itself or the medication) or psychological factors (fear of harming the transplanted organ), mood disorders that decrease postoperation adherence to treatment and that can cause organ rejection, anxiety disorders, especially when patients are discharged, fantasies about the donor that can lead to feelings of guilt because they think the donor died so they could live, and dissatisfaction with body image, because they perceive the organ as a foreign object that transfers the donor's traits to them. Other studies have attempted to identify the most stressful situations for patients, which can have negative consequences on their evolution: for example, uncertainty about their future health, secondary effects of medication, limitations associated with their physical status, and medical prescriptions (Achille et al., 2004; Dew, Myaskovsky, Switzer, DiMartini, & Kormos, 2005). …

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