TY - JOUR
T1 - The relation between psychological distress and medication adherence in lung transplant candidates and recipients
T2 - A cross-sectional study
AU - Wessels-Bakker, Marion J.
AU - van de Graaf, Eduard A.
AU - Kwakkel-van Erp, Johanna M.
AU - Heijerman, Harry G.
AU - Cahn, Wiepke
AU - Schappin, Renske
N1 - Funding Information:
We gratefully thank all lung transplant patients for their participation. We want to acknowledge M.E. Janssen and I. van Ewijk-Hagenaar for participation in the data collection and J.H. Annema for her feedback on the draft of this manuscript
Publisher Copyright:
© 2021 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
PY - 2022/3
Y1 - 2022/3
N2 - Aims and objectives: To explore the prevalence of psychological distress such as anxiety, depression and post-traumatic stress disorder and its associations with medication adherence in lung transplant patients. Background: Psychological distress after lung transplantation may impact clinical outcomes by associated behaviours such as non-adherence to medication. Evidence about the relation between psychological distress and medication adherence in lung transplant patients is limited and not well explained. Design and methods: We conducted a single-centre study with a cross-sectional design in 73 lung transplant candidates and 116 recipients. Questionnaires were the Brief Symptom Inventory, Impact of Event Scale and Basel Assessment of Adherence to Immunosuppressive Medications Scale. The STROBE checklist was monitored. Results: In candidates, 39.7% reported (sub)clinical symptoms of depression, in recipients this was 21.6%. We observed suicidal ideation in recipients (8.6%), and candidates (5.5%). The prevalence of (sub)clinical symptoms of anxiety was 38.3% in candidates and 33.7% in recipients. After lung transplantation, 12% of the recipients reported clinical symptoms of PTSD related to the transplantation. Symptoms of anxiety and medication adherence were significantly and positively related in transplant recipients. We found no association between depressive or post-traumatic stress symptoms, and medication adherence. Conclusions: In lung transplant patients, we found a high prevalence of symptoms of depression and anxiety. Recipients had high levels of post-traumatic stress symptoms related to the transplantation. The prevalence of suicidal ideation was unexpectedly high in recipients. After lung transplantation, higher levels of anxiety were related to better medication adherence. We propose that LTX recipients are very anxious to develop dyspnoea and therefore take their medication more conscientiously. Relevance to clinical practice: The clinical nurse specialist can play a key role in identifying and addressing psychological and behavioural problems. More prospective research on the role of anxiety and dyspnoea in lung transplant recipients is recommended.
AB - Aims and objectives: To explore the prevalence of psychological distress such as anxiety, depression and post-traumatic stress disorder and its associations with medication adherence in lung transplant patients. Background: Psychological distress after lung transplantation may impact clinical outcomes by associated behaviours such as non-adherence to medication. Evidence about the relation between psychological distress and medication adherence in lung transplant patients is limited and not well explained. Design and methods: We conducted a single-centre study with a cross-sectional design in 73 lung transplant candidates and 116 recipients. Questionnaires were the Brief Symptom Inventory, Impact of Event Scale and Basel Assessment of Adherence to Immunosuppressive Medications Scale. The STROBE checklist was monitored. Results: In candidates, 39.7% reported (sub)clinical symptoms of depression, in recipients this was 21.6%. We observed suicidal ideation in recipients (8.6%), and candidates (5.5%). The prevalence of (sub)clinical symptoms of anxiety was 38.3% in candidates and 33.7% in recipients. After lung transplantation, 12% of the recipients reported clinical symptoms of PTSD related to the transplantation. Symptoms of anxiety and medication adherence were significantly and positively related in transplant recipients. We found no association between depressive or post-traumatic stress symptoms, and medication adherence. Conclusions: In lung transplant patients, we found a high prevalence of symptoms of depression and anxiety. Recipients had high levels of post-traumatic stress symptoms related to the transplantation. The prevalence of suicidal ideation was unexpectedly high in recipients. After lung transplantation, higher levels of anxiety were related to better medication adherence. We propose that LTX recipients are very anxious to develop dyspnoea and therefore take their medication more conscientiously. Relevance to clinical practice: The clinical nurse specialist can play a key role in identifying and addressing psychological and behavioural problems. More prospective research on the role of anxiety and dyspnoea in lung transplant recipients is recommended.
KW - anxiety
KW - depression
KW - lung transplantation
KW - medication adherence
KW - post-traumatic stress disorder
KW - suicidal ideation
KW - Medication Adherence
KW - Lung Transplantation/adverse effects
KW - Prospective Studies
KW - Cross-Sectional Studies
KW - Humans
KW - Psychological Distress
UR - http://www.scopus.com/inward/record.url?scp=85109040140&partnerID=8YFLogxK
U2 - 10.1111/jocn.15931
DO - 10.1111/jocn.15931
M3 - Article
C2 - 34216066
AN - SCOPUS:85109040140
SN - 0962-1067
VL - 31
SP - 716
EP - 725
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
IS - 5-6
ER -