Candidates for liver transplantation for cancer: physical, psychological, and social conditions.
BACKGROUND
There is little knowledge of the psychological and social conditions of candidates for liver transplantation and the meaning that these patients attribute to those conditions.


METHODS
The research has been conducted with quantitative and qualitative methods. For the quantitative study, 80 patients were assessed with four evaluation instruments: the Interdisciplinary Group for Cancer Care Evaluation in Italy (GIVIO) questionnaire for quality of life, the Needs Evaluation Questionnaire (NEQ) for psychosocial needs, the Minnesota Multiphasic Personality Inventory (MMPI) personality test, and a questionnaire for the family's reactions to the illness. The qualitative evaluation was conducted to better understand the meaning of the transplantation as expressed by the patients, the integration of the new organ, and the symbolic relationship with the donor with particular attention to the different levels of patients' awareness.


RESULTS
The quantitative evaluation showed a good level of quality of life assessed by GIVIO and a low prevalence in the personality disorder scales detected by the MMPI. The patients' needs assessed by NEQ showed a high need of information about the future conditions (77%) followed by the need for more explanation of examinations (49%) and treatments (50%). The qualitative study identified and analyzed two opposite groups of five patients each: those who did not recognize and did not express any emotional experience and those who recognized and expressed a particularly intense emotional experience.


CONCLUSIONS
The psychosocial condition of transplant candidates with liver cancer is characterized by an impact that is more psychological than physical. The qualitative analysis performed allows the hypothesis that the patient's level of awareness is an important indicator to predict the type of adaptation after transplantation.
Gangeri
Laura
L
Psychology and Liver Surgery and Transplantation Units, National Cancer Institute, 20133 Milan, Italy. gangeri@istitutotumori.mi.it
Tamburini
Marcello
M
Borreani
Claudia
C
Brunelli
Cinzia
C
Miccinesi
Guido
G
Murru
Luciana
L
Boeri
Paolo
P
Mazzaferro
Vincenzo
V
D001294:Attitude to Health; D003071:Cognition / Q000502:physiology; D004644:Emotions; D004651:Employment; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008113:Liver Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D010554:Personality Disorders / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires