Psychosocial vulnerability predicts psychosocial outcome after an organ transplant: Results of a prospective study with lung, liver, and bone-marrow patients

Goetzmann, Lutz; Klaghofer, Richard; Wagner-Huber, Regula; Halter, Jörg; Boehler, Annette; Muellhaupt, Beat; Schanz, Urs; Buddeberg, Claus

doi:10.1016/j.jpsychores.2006.07.023

« Previous Next »Journal of Psychosomatic Research
Volume 62, Issue 1 , Pages 93-100, January 2007

Psychosocial vulnerability predicts psychosocial outcome after an organ transplant: Results of a prospective study with lung, liver, and bone-marrow patients☆

Lutz Goetzmann
- Department of Psychosocial Medicine, University Hospital Zurich, Zurich, Switzerland
- Corresponding author. Department of Psychosocial Medicine, University Hospital Zurich, Haldenbachstrasse 18, CH-8091 Zürich, Switzerland. Tel.: +41 1 255 52 52; fax: +41 1 255 4384.
Richard Klaghofer
- Department of Psychosocial Medicine, University Hospital Zurich, Zurich, Switzerland
Regula Wagner-Huber
- Department of Psychosocial Medicine, University Hospital Zurich, Zurich, Switzerland
Jörg Halter
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
Annette Boehler
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
Beat Muellhaupt
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
Urs Schanz
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
Claus Buddeberg
- Department of Psychosocial Medicine, University Hospital Zurich, Zurich, Switzerland

Received 6 April 2006; received in revised form 5 June 2006; accepted 11 July 2006.

Abstract

Objective

The pretransplant medical evaluation of transplantation candidates includes an assessment of psychosocial data. This study investigates psychosocial vulnerability as a predictor of posttransplant outcome.

Methods

Seventy-six patients were assessed prior to lung, liver, or bone-marrow transplant. Pretransplant vulnerability markers were cognitive beliefs (sense of coherence and optimism), affect (anxiety and depression), and external resources (social support). In addition, psychosocial functioning was assessed by professionals. Quality of life, general life satisfaction, need for counseling, and survival rate were assessed 12 months after transplant.

Results

Pretransplant variables explain 21–40% of the variance in posttransplant psychosocial outcome variables. Cognitive beliefs predict mental quality of life; affect (depression) and social support predict life satisfaction; and expert-rated psychosocial functioning predicts life satisfaction and need for counseling.

Conclusion

The multidimensional vulnerability model is suitable for predicting posttransplant psychosocial outcome. Patients with high pretransplant vulnerability should receive ongoing psychosocial counseling.

Keywords: Organ transplantation, Vulnerability, Stressor, Prediction, Outcome, Quality of life, Counseling