Psychosocial vulnerability, physical symptoms and physical impairment after lung and heart-lung transplantation.
BACKGROUND
Many lung and heart-lung transplant recipients experience distressing physical symptoms and elevated physical impairment levels. Although post-transplant complications and secondary illnesses may largely account for these health limitations, patients' psychosocial well-being may influence them as well. We examined the contribution of psychosocial variables to patients' experience of physical symptoms and physical impairment.


METHODS
The study consisted of a cross-sectional sample of 50 patients (36 lung, 14 heart-lung) at between 2 and 17 months post-transplant. They were interviewed to assess physical symptoms, current physical impairment and psychosocial well-being in the areas of mental health, sense of mastery and coping. Medical record reviews established the presence of medical complications and secondary illnesses concurrent with the interviews. Descriptive analyses examined the range of symptoms and levels of physical impairment experienced. Bivariate analyses and multivariate linear regression examined relationships between key variables.


RESULTS
Average number of physical symptoms and level of physical impairment met or exceeded levels reported in other transplant samples. Elevated depressive and anxiety symptoms, a low sense of mastery, and the presence of concurrent medical complications were each associated with increased number of physical symptoms and physical impairment level. When the impact of concurrent medical complications was controlled, recipients with elevated psychologic distress remained significantly more likely to report more physical symptoms and higher physical impairment levels.


CONCLUSIONS
Patients' physical health status may be influenced by many factors. To the extent that psychologic distress increases the likelihood of perceived physical limitations, timely identification and treatment of distress may help to maximize quality of life after lung and heart-lung transplantation.
Department of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Annette
A
De Vito Dabbs
Mary Amanda
MA
Dew
Carol S
CS
Stilley
Jan
J
Manzetti
Thomas
T
Zullo
Kenneth R
KR
McCurry
Robert L
RL
Kormos
Aldo
A
Iacono
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D016041:Heart-Lung Transplantation / Q000009:adverse effects* / Q000523:psychology; D006801:Humans; D016014:Linear Models; D016040:Lung Transplantation / Q000009:adverse effects* / Q000523:psychology; D008297:Male; D008499:Medical Records; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors