title: The Transplanted Organ Questionnaire: a validation study.
abstract: OBJECTIVE
  The transplanted organ is a key element of the recipient's daily life. But its representations are neither spontaneously expressed by patients, nor taken into account by transplantation professionals. Our objective was to assess specifically the transplanted organ representations in liver transplant recipients.
  
  
  METHODS
  In a prospective cohort study, 134 liver transplanted (LT) patients were assessed using the Transplanted Organ Questionnaire (TOQ), a new specifically designed questionnaire, fulfilled 3, 6, 12, 24, and 36months post-LT.
  
  
  RESULTS
  The TOQ comprised three dimensions, explaining 44% of the total variance: Donor (21.3%) measuring the recipients' concerns about the donor, Positive attitude towards the transplant (13.4%), and Psychological Rejection (9.3%), measuring a lack of incorporation of the transplant. These three dimensions have a high internal consistency (Cronbach alpha: 0.91, 0.76 and 0.56) and are stable over time. Older recipients had more concern about the Donor than younger ones. As compared to other medical primary diagnoses, viral hepatitis was associated with higher scores on the subscales Positive attitude towards the transplant and Psychological Rejection. Interestingly, Psychological rejection predicted increased long term risk of death (HR, 1.20; 95% CI, 1.01-1.44, P=.046) under multivariate Cox analyses, independently from other variables.
  
  
  CONCLUSIONS
  The transplanted organ representations as specifically assessed by the Transplanted Organ Questionnaire (TOQ) are relevant in liver transplant recipients. Interventions based on the transplant representations after LT should be assessed in further studies. Indeed, preventing psychological rejection of the transplanted organ and facilitating its psychological incorporation may decrease long term mortality after LT.
authors.affiliation: INSERM U 669, Paris XI University, Psychiatry Department of Bicetre University Hospital, Assistance Publique - Hopitaux de Paris, 94275 Le Kremlin Bicêtre, France. emmanuelle.corruble@bct.aphp.fr
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Corruble
authors.forename: Caroline
authors.initials: C
authors.lastname: Barry
authors.forename: Isabelle
authors.initials: I
authors.lastname: Varescon
authors.forename: Denis
authors.initials: D
authors.lastname: Castaing
authors.forename: Didier
authors.initials: D
authors.lastname: Samuel
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires