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. 2025 Jan 17:15:1481643.
doi: 10.3389/fpsyg.2024.1481643. eCollection 2024.

Pilot implementation of two specific problem lists before and after solid organ transplantation into routine care

Sanna Higgen  1 , Evamaria Müller  1 , Markus J Barten  2   3 , Doreen Eickhoff  1   3 , Florian Grahammer  4 , Martin Härter  1 , Sabine Bart  5 , Martina R Sterneck  3   6 , Angela Buchholz  1   3
Affiliations

Pilot implementation of two specific problem lists before and after solid organ transplantation into routine care

Sanna Higgen et al. Front Psychol. .

Abstract

Introduction: Psychosocial distress and mental health problems are common in patients before and after solid organ transplantation and can negatively affect morbidity, mortality, and adherence. Even though regular screening is recommended to identify patients with high levels of distress, the implementation in routine care has been insufficient so far.

Methods: Two newly developed problem lists for patients before and after transplantations were pilot implemented for 8 weeks at the Medical Center Hamburg Eppendorf (UKE) to identify factors facilitating and impeding their implementation.

Results: Health care professionals evaluated its appropriateness, feasibility, and the cooperation with the psychologists before (HCPs: n = 23) and after (HCPs: n = 19) the implementation. Four psychologists assessed the appropriateness and feasibility by answering to open-ended and close-ended questions. Additionally, patients before (n = 8) and after (n = 100) transplantation filled out the screening and rated its acceptance. Only the data of the patients after transplantation were analyzed due to the small sample size of patients before transplantation. HCPs and psychologists rated the screenings as very appropriate [HCPs: M = 3.84 (SD = 0.77) to M = 4.32 (SD = 0.58)]. It was also highly accepted among patients [M = 4.23 (SD = 0.85) to M = 4.68 (SD = 0.65)]. Contentment with the psychological support and understanding of the mental health problems among HCPs increased significantly from before to after the implementation (U = 107.50, p < 0.05, r = 0.33; U = 107.00, p < 0.05, r = 0.34). The feasibility of the problem list post-Tx in routine care, however, was seen as challenging [HCPs: M = 3.11 (SD = 1.05) to M = 3.47 (SD = 1.07)].

Discussion: The distress screening was accepted and improved the cooperation between different professions. Barriers to implementation can be lack of staff and resources. Future studies should assess the adoption and sustainability of the screening in routine care.

Keywords: implementation research; organ transplantation; psychological distress; symptom assessment; transplant recipients.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Cooperation with psychological staff before and after implementation of the screening: scale 1 (I do not agree) to 5 (I agree); * p < 0.05.
See this image and copyright information in PMC

References

    1. Achille M. A., Ouellette A., Fournier S., Vachon M., Hebert M. J. (2006). Impact of stress, distress and feelings of indebtedness on adherence to immunosuppressants following kidney transplantation. Clin. Transpl. 20, 301–306. doi: 10.1111/j.1399-0012.2005.00478.x, PMID: - DOI - PubMed
    1. Annema C., Roodbol P. F., Stewart R. E., Porte R. J., Ranchor A. V. (2015). Prevalence of psychological problems and associated transplant-related variables at different time periods after liver transplantation. Liver Transpl. 21, 524–538. doi: 10.1002/lt.24075, PMID: - DOI - PubMed
    1. Baranyi A., Krauseneck T., Rothenhäusler H.-B. (2013). Overall mental distress and health-related quality of life after solid-organ transplantation results from a retrospective follow-up study. Health Qual. Life Outcomes 11:15. doi: 10.1186/1477-7525-11-15, PMID: - DOI - PMC - PubMed
    1. Bartholomew N. G., Joe G. W., Rowan-Szal G. A., Simpson D. D. (2007). Counselor assessments of training and adoption barriers. J. Subst. Abus. Treat. 33, 193–199. doi: 10.1016/j.jsat.2007.01.005, PMID: - DOI - PMC - PubMed
    1. Brennan J., Gingell P., Brant H., Hollingworth W. (2012). Refinement of the distress management problem list as the basis for a holistic therapeutic conversation among UK patients with cancer. Psychooncology 21, 1346–1356. doi: 10.1002/pon.2045 - DOI - PubMed

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