Müller Evamaria, Härter Martin, Higgen Sanna, Barten Markus J, Eickhoff Doreen, Grahammer Florian, Reinsberg Nele, 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 May 13;16:1481641. doi: 10.3389/fpsyg.2025.1481641. eCollection 2025.
Psychosocial distress is common in patients before and after solid organ transplantation. Regular screening facilitates the early identification of distressed patients and the provision of appropriate professional care. However, feasible screening tools that address the specific problems of transplant patients are missing. Thus, the aim of this mixed methods study was to develop transplant-specific problem lists for patients before (transplant candidates) and after (transplant recipients) solid organ transplantation which can be used as a quick and easily applicable screening tool for psychosocial distress.
An electronic database search resulted in a preliminary item list including 36 problems common in transplant candidates and 44 problems in transplant recipients. A total of = 117 patients and = 48 health care providers participated in a paper-pencil survey to assess the relevance and comprehensibility of the problem lists. Qualitative interviews about the clarity and completeness of problem lists were performed with = 58 patients and = 3 transplant nurses. Data analysis included the calculation of descriptive statistics and content analysis of interviews and survey open response fields. To test the concurrent validity of the problem list for patients, patients completed the problem list in combination with the National Comprehensive Cancer Network (NCNN) distress thermometer and a short form of the Patient Health Questionnaire (PHQ-4) as part of routine care.
The finalized list for transplant candidates includes 21 items and the list for transplant recipients 22 items, each covering four categories: problems in everyday life, social problems, worries and anxieties, physical and psychological problems. In the course of the study, sufficient data was gathered only from transplant recipients ( = 100). The number of problems endorsed by transplant recipients correlated significantly with measures of depression and distress (distress: = 0.41, < 0.001; PHQ-4: = 0.63, < 0.001; PHQ-2: = 0.53, < 0.001; GAD-2: = 0.60, < 0.001). The developed problem lists cover relevant psychosocial problems and can help to identify distress in patients before and after transplantation.
The problem list for transplant recipients showed sufficient concurrent validity, psychometric properties of the problem list for transplant candidates should be investigated in further studies.
社会心理困扰在实体器官移植患者术前及术后都很常见。定期筛查有助于早期识别困扰患者并提供适当的专业护理。然而，针对移植患者特定问题的可行筛查工具尚不存在。因此，这项混合方法研究的目的是为实体器官移植术前（移植候选人）和术后（移植受者）的患者制定特定于移植的问题清单，该清单可作为一种快速且易于应用的社会心理困扰筛查工具。
电子数据库检索得出一份初步项目清单，其中包括移植候选人中常见的36个问题和移植受者中常见的44个问题。共有117名患者和48名医疗保健提供者参与了纸笔调查，以评估问题清单的相关性和可理解性。对58名患者和3名移植护士进行了关于问题清单清晰度和完整性的定性访谈。数据分析包括描述性统计计算以及对访谈和调查开放式回答字段的内容分析。为了测试患者问题清单的同时效度，患者在常规护理中结合国家综合癌症网络（NCNN）困扰温度计和患者健康问卷简表（PHQ - 4）完成了问题清单。
移植候选人的最终清单包括21项，移植受者的清单包括22项，每项涵盖四个类别：日常生活问题、社会问题、担忧与焦虑、身体和心理问题。在研究过程中，仅从100名移植受者那里收集到了足够的数据。移植受者认可的问题数量与抑郁和困扰程度的测量指标显著相关（困扰：r = 0.41，p < 0.001；PHQ - 4：r = 0.63，p < 0.001；PHQ - 2：r = 0.53，p < 0.001；GAD - 2：r = 0.60，p < 0.001）。所制定的问题清单涵盖了相关的社会心理问题，有助于识别移植前后患者的困扰。
移植受者的问题清单显示出足够的同时效度，移植候选人问题清单的心理测量特性应在进一步研究中进行调查。
