title: A thematic analysis of quality of life in lung transplant: the existing evidence and implications for future directions.
abstract: Health-related quality of life (HRQL) has been assessed in various lung transplantation (LT) investigations but never analyzed systematically across multiple studies. We addressed this knowledge gap through a systematic literature review. We searched the PubMed, CINAHL and PsychInfo databases for publications from January 1, 1983 to December 31, 2011. We performed a thematic analysis of published studies of HRQL in LT. Using a comparative, consensus-based approach, we identified themes that consistently emerged from the data, classifying each study according to primary and secondary thematic categories as well as by study design. Of 749 publications initially identified, 73 remained after exclusions. Seven core themes emerged: (1) Determinants of HRQL; (2) Psychosocial factors in HRQL; (3) Pre- and posttransplant HRQL comparisons; (4) Long-term longitudinal HRQL studies; (5) HRQL effects of therapies and interventions; (6) HRQL instrument validation and methodology; (7) HRQL prediction of clinical outcomes. Overall, LT significantly and substantially improves HRQL, predominantly in domains related to physical health and functioning. The existing literature demonstrates substantial heterogeneity in methodology and approach; relatively few studies assessed HRQL longitudinally within the same persons. Opportunity for future study lies in validating existing and potential novel HRQL instruments and further elucidating the determinants of HRQL through longitudinal multidimensional investigation.
authors: Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, CA.|Cardiovascular Research Institute, UC San Francisco, San Francisco, CA.
authors: J P
authors: JP
authors: Singer
authors: Cardiovascular Research Institute, UC San Francisco, San Francisco, CA.
authors: J
authors: J
authors: Chen
authors: Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, CA.|Cardiovascular Research Institute, UC San Francisco, San Francisco, CA.|Division of Occupational and Environmental Medicine, UC San Francisco, CA.
authors: P D
authors: PD
authors: Blanc
authors: Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, CA.
authors: L E
authors: LE
authors: Leard
authors: Division of Cardiothoracic Surgery, UC San Francisco, CA.
authors: J
authors: J
authors: Kukreja
authors: Genentech Inc, San Francisco, CA.
authors: H
authors: H
authors: Chen
mesh_terms: D003657:Decision Making; D006801:Humans; D008171:Lung Diseases / Q000523:psychology / Q000628:therapy; D016040:Lung Transplantation / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome