title: Trajectories of change in quality of life in 12-month survivors of lung or heart transplant.
abstract: Survival and functional outcomes for lung transplant recipients continue to lag behind those for heart recipients. Whether these poorer physical outcomes translate into poorer quality of life (QOL) for lung recipients relative to heart recipients is unknown. Lung versus heart transplant recipients' perceptions of QOL were longitudinally compared at three time-points across the first year posttransplant. Additionally, potentially important predictors of patient QOL were examined. Adult transplant recipients (N = 199) participated in semi-structured interviews that included measures of QOL, optimism, mastery, social support, religiosity and coping. Temporal patterns of QOL change were compared between lung and heart recipients who survived until 1 year posttransplant using mixed-model, hierarchical analysis of variance (ANOVA). Demographic and psychosocial predictors were examined with multiple regression analysis to identify the unique effects of each variable on QOL 1 year posttransplant. While heart recipients' QOL across several domains was higher shortly after transplant, lung patients' QOL improved and was equivalent to that of heart recipients by 1 year posttransplant. Greater optimism and support from friends predicted better QOL in physical, psychological and social domains. Conversely, avoidant coping strategies predicted poorer physical functioning. Thus, while clinical interventions designed to improve QOL posttransplant should be tailored to transplant recipients' initial psychosocial assets and liabilities, they need not be distinguished by transplant type.
authors.affiliation: V.A. Center for Health Equity Research and Promotion, University of Pittsburgh, Pennsylvania, USA. myaskovskyl@upmc.edu
authors.forename: L
authors.initials: L
authors.lastname: Myaskovsky
authors.forename: M A
authors.initials: MA
authors.lastname: Dew
authors.forename: M L
authors.initials: ML
authors.lastname: McNulty
authors.forename: G E
authors.initials: GE
authors.lastname: Switzer
authors.forename: A F
authors.initials: AF
authors.lastname: DiMartini
authors.forename: R L
authors.initials: RL
authors.lastname: Kormos
authors.forename: K R
authors.initials: KR
authors.lastname: McCurry
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006262:Health; D016027:Heart Transplantation; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome