Liver transplantation
Candidate
Psychosocial Profile of Patients on the Liver Transplant List

https://doi.org/10.1016/j.transproceed.2008.02.040Get rights and content

Abstract

Introduction

Researchers have shown that psychosocial factors influence adherence to treatment and, consequently, prognosis. Psychosocial assessment during the preoperative outpatient phase has allowed physicians to make better treatment decisions.

Objectives

We sought to describe the psychosocial profile of patients on the liver transplant list referred for psychological assessment.

Method

We reviewed all files of patients referred for pretransplant psychological assessment over a 14-month period.

Results

The sample included 73 patients: mean age 49.46 ± 11.18 years and; mean formal schooling 7.35 ± 4.65 years. Of those, 56.1% reported a cognitive complaint; 33%, symptoms of anxiety, and 17%, depression. Of the sample, 45.8% were referred for alcohol use, and 37.5% for mood changes. During the assessment, 15.9%, 34.4%, and 1.6%, of patients reported using alcohol, tobacco, or some other type of drug, respectively. Of patients, 53.6% reported having used alcohol at some point in their life—26% tobacco and 10.9% some other type of drug. After the assessment, the main referrals were 35.6% to family counseling, 32.1% to cognitive assessment, and 28.5% to psychological counseling.

Conclusion

This study highlighted the prevalence of cognitive complaints and current/previous use of chemical substances. These findings were identified through psychological inquiry, which was able to direct the individual treatments. Although these conditions prevailed among this population, their early detection allowed for early intervention to improve adherence and minimize possible intervening problems.

Section snippets

Participants

We reviewed all files of patients referred for pretransplant psychological assessment for liver transplantation from August 2005 to October 2006.

Instrument

The psychological evaluation protocol used specific scales to cover the following items: demographics, productive activity, family history, understanding of the disease, understanding of nutrition, history of adherence to treatment, use of alcohol, tobacco or illicit drugs, understanding of the transplantation process, expectations about the

Results

Of the 160 patients on the liver transplant list over the 14-month period, 73 (45.6%) were referred by the transplant team for psychological evaluation. Their demographic distribution is shown in Table 1.

According to the results, each patient had 2.88 (±1.58) psychologist appointments, which is to be expected; the protocol foresaw an average of three appointments per evaluation. Among the evaluated patients, 75.3% were male, most of them were married (71.2%), and Catholic (71%). The overall

Discussion

Based on the psychosocial profiles of the evaluated patients, we noted a high prevalence of male patients, most with little schooling and a history of previous or current alcohol and tobacco use. We have to highlight the fact that the psychological evaluation identified more cases of history or suspicion of alcohol use (69.5%) than the number of patients referred to psychological assessment by the transplant team for this specific reason. The evaluation of the psychosocial profile of patients

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