Higgen Sanna, Müller Evamaria, Barten Markus J, Eickhoff Doreen, Grahammer Florian, Härter Martin, Bart Sabine, Sterneck Martina R, Buchholz Angela
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Front Psychol. 2025 Jan 17;15:1481643. doi: 10.3389/fpsyg.2024.1481643. eCollection 2024.
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.
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.
Health care professionals evaluated its appropriateness, feasibility, and the cooperation with the psychologists before (HCPs: = 23) and after (HCPs: = 19) the implementation. Four psychologists assessed the appropriateness and feasibility by answering to open-ended and close-ended questions. Additionally, patients before ( = 8) and after ( = 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: = 3.84 (SD = 0.77) to = 4.32 (SD = 0.58)]. It was also highly accepted among patients [ = 4.23 (SD = 0.85) to = 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 ( = 107.50, < 0.05, = 0.33; = 107.00, < 0.05, = 0.34). The feasibility of the problem list post-Tx in routine care, however, was seen as challenging [HCPs: = 3.11 (SD = 1.05) to = 3.47 (SD = 1.07)].
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.
社会心理困扰和心理健康问题在实体器官移植前后的患者中很常见，并且会对发病率、死亡率和依从性产生负面影响。尽管建议进行定期筛查以识别困扰程度较高的患者，但到目前为止，在常规护理中的实施情况并不充分。
在汉堡埃彭多夫医疗中心（UKE）对两个新开发的移植前后患者问题清单进行了为期8周的试点实施，以确定促进和阻碍其实施的因素。
医疗保健专业人员在实施前（医疗保健专业人员：n = 23）和实施后（医疗保健专业人员：n = 19）评估了其适用性、可行性以及与心理学家的合作情况。四位心理学家通过回答开放式和封闭式问题评估了其适用性和可行性。此外，移植前（n = 8）和移植后（n = 100）的患者填写了筛查问卷并对其接受程度进行了评分。由于移植前患者样本量较小，仅分析了移植后患者的数据。医疗保健专业人员和心理学家将筛查评为非常合适[医疗保健专业人员：评分从3.84（标准差 = 0.77）到4.32（标准差 = 0.58）]。在患者中也得到了高度认可[评分从4.23（标准差 = 0.85）到4.68（标准差 = 0.65）]。实施后，医疗保健专业人员对心理支持的满意度以及对心理健康问题的理解较实施前显著提高（t = 107.50，p < 0.05，r = 0.33；t = 107.00，p < 0.05，r = 0.34）。然而，移植后问题清单在常规护理中的可行性被认为具有挑战性[医疗保健专业人员：评分从3.11（标准差 = 1.05）到3.47（标准差 = 1.07）]。
困扰筛查得到了认可，并改善了不同专业之间的合作。实施的障碍可能是人员和资源的缺乏。未来的研究应评估筛查在常规护理中的采用情况和可持续性。
