title: Psycho-social outcome in liver transplanted children: beware of emotional self-assessment!
abstract: BACKGROUND
  Psycho-social outcome in children after liver transplantation (LT) is known to be inferior to age-related peers. Yet, when children and their parents are questioned by their nurse or physician about the child's psycho-social well-being, the answers usually are very positive. We hypothesized that patients and their parents after LT report their psycho-social well-being too enthusiastically when enquired by their personal care takers.
  
  
  METHODS
  
  
  
  METHODS
  LT at the Children's University Hospital of Geneva 1992-2007, age >3 years, <16 years, time after LT >2 years. Children and their parents were questioned by their well-known, familiar nurse at the annual follow up visit about their personal well-being. To allow for evaluation of answers, scores (good, medium, bad) were attributed to the different questions. 46 children were included in the study.
  
  
  RESULTS
  Mean age at enquiry was 9.7 years (SD 4 years), mean time after LT was 7.5 years (SD 4.2 years). The different themes were reported as good for: parent-child relationship (83%), relationship with peers (98%), relation with siblings (39%), sport activities (54%), play activities (78%), school performance (87%), expression skills (67%), and general behavior (89%).
  
  
  CONCLUSIONS
  Most of our LT children and their parents consider, during a personal interview with a closely related, familiar nurse, that the child's psycho-social outcome is good. Yet, it is generally acknowledged that children after LT have negatively altered psycho-social outcomes. Thus, emotionally influenced reports about psycho-social outcome in children after LT must be looked at with care.
authors.affiliation: Division of Pediatric Surgery, Department of Pediatrics, University Children's Hospital of Geneva, Geneva, Switzerland.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Calinescu
authors.forename: Valérie A
authors.initials: VA
authors.lastname: McLin
authors.forename: Dominque
authors.initials: D
authors.lastname: Belli
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Wildhaber
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004644:Emotions; D005195:Family Relations; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D011788:Quality of Life; D012647:Self-Assessment; D012944:Social Support; D011795:Surveys and Questionnaires