title: Waiting for a liver transplant: psychosocial well-being, spirituality, and need for counselling.
abstract: The number of patients in need of a liver transplant vastly exceeds the number of available organs; the demand worldwide for organs leads to increased waiting times and mortality of patients on the waiting list. The aim of our study was to assess the psychosocial well-being of transplant candidates and their need for psychosocial counselling.
  
  
  METHODS
  Sixty-nine liver transplant candidates were asked about their psychosocial well-being, quality of life, spirituality, and need for counselling assessed by interview and questionnaire (HADS-D, FLZ, LOT, SOC, SF-36, SBI-15R) during the initial evaluation procedure for organ transplantation as well as 3 and 6 months after listing.
  
  
  RESULTS
  Candidates for a liver transplant exhibited a significant limitation in the levels of their quality of life and psychological well-being, compared with the community normal samples. They showed significantly higher levels of anxiety, but lower levels of spirituality. Almost half of the candidates (47%) expressed a need for counselling during the evaluation procedure. Patients with advanced diseases reported a lower need. Age and the personality-related "Sense of Coherence" correlated negatively with need for counselling. On the waiting list, psychosocial parameters and functions remained largely stable; the need for counselling decreased significantly.
  
  
  CONCLUSIONS
  There is a relevant need for psychosocial counselling during the process of liver transplant evaluation. Need for counselling is associated with personality and age, as well as with somatic parameters.
authors.affiliation: University Hospital Zurich, Zurich, Switzerland. lutz.goetzmann@usz.ch
authors.forename: L
authors.initials: L
authors.lastname: Goetzmann
authors.forename: R
authors.initials: R
authors.lastname: Wagner-Huber
authors.forename: R
authors.initials: R
authors.lastname: Klaghofer
authors.forename: B
authors.initials: B
authors.lastname: Muellhaupt
authors.forename: P A
authors.initials: PA
authors.lastname: Clavien
authors.forename: C
authors.initials: C
authors.lastname: Buddeberg
authors.forename: E
authors.initials: E
authors.lastname: Scheuer
mesh_terms: D000328:Adult; D000368:Aged; D003376:Counseling; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016031:Liver Transplantation / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011788:Quality of Life; D012917:Social Adjustment; D029181:Spirituality; D011795:Surveys and Questionnaires; D013557:Switzerland; D014850:Waiting Lists