title: Psychological processing of transplantation in lung recipients: a quantitative study of organ integration and the relationship to the donor.
abstract: OBJECTIVE
  Lung recipients undergo a complex psychological process, including organ integration and processing of attitudes towards the organ donor.
  
  
  METHODS
  Seventy-six lung recipients were asked to participate in a cross-sectional questionnaire study on the psychological processing of lung transplants.
  
  
  METHODS
  The questionnaire consisted of statements describing aspects of organ integration and the patient's relationship with the donor. Furthermore, chronic stress/psychological distress (Screening Scale of the Trier Inventory; Symptom Checklist SCL-K-9) and the emotional effects of transplantation/immunosuppression (Transplant Effects Questionnaire; Medication Experience Scale for Immunosuppressants) were assessed.
  
  
  RESULTS
  In general, lung recipients perceive the transplant as part of themselves (97.4%) and not as a foreign object (90%). One-third of patients still have frequent thoughts about the donor, whilst the majority (80.3%) do not believe that they have adopted the donor's characteristic traits. Factor analysis reveals the two-dimensional structure of the questionnaire items 'organ integration' (factor 1) and 'relationship to the donor' (factor 2). Poor organ integration predicts low adherence, low disclosure and high feelings of guilt, whilst a close donor relationship predicts chronic stress and psychological distress.
  
  
  CONCLUSIONS
  Poor organ integration and a close relationship to the donor should be borne in mind in psychosocial treatment regarding the patient's adherence behaviour and psychological distress.
authors.affiliation: Psychosocial Medicine, University Hospital Zurich, Zurich, Switzerland. lutz.goetzmann@usz.ch
authors.forename: Lutz
authors.initials: L
authors.lastname: Goetzmann
authors.forename: Sarosh
authors.initials: S
authors.lastname: Irani
authors.forename: Karin S
authors.initials: KS
authors.lastname: Moser
authors.forename: Kyrill
authors.initials: K
authors.lastname: Schwegler
authors.forename: Martina
authors.initials: M
authors.lastname: Stamm
authors.forename: Anja
authors.initials: A
authors.lastname: Spindler
authors.forename: Claus
authors.initials: C
authors.lastname: Buddeberg
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
authors.forename: Richard
authors.initials: R
authors.lastname: Klaghofer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013557:Switzerland; D014019:Tissue Donors; D055815:Young Adult