Evolution of liver transplant patients at high psychosocial risk

Liver transplant recipients: individual, social, and environmental resources

CONTEXT

Patient characteristics are important in the liver transplant population because of proven associations between individual and environmental factors, treatment adherence, and health outcomes in general medical and other transplant populations.

OBJECTIVE

To determine generalizability of the sample to other liver transplant populations and to establish reliability of measures used to assess individual and environmental resources.

DESIGN

Cross-sectional analysis of baseline data in a longitudinal study of adherence and health outcomes.

PARTICIPANTS, SETTING

Ninety first-time adult liver transplant recipients at the University of Pittsburgh Medical Center completed assessments of sociodemographic, health history, psychosocial, and environmental factors shortly after surgery; adherence and health outcomes were tracked throughout the study.

RESULTS

The medical center cohort was older, less racially diverse, and contained more living donors than the national sample. Our sample was generally comparable to the medical center cohort on pretransplant sociodemographic and clinical characteristics. Reliability/internal consistency on psychological measures was similar between our sample and most published norms. The mean scores on all coping scales in our sample were higher than normative. Our patients indicated a more negative perception of family environment and perceived relationships with their primary caregiver more positively than did the normative group.

CONCLUSION

The generalizability of our sample to the parent population and reliability of individual and environmental measures reported here will enable us to examine relationships and the value of patient and contextual resources for predicting treatment adherence and health outcomes among liver transplant recipients.

Liver Transplant Recipients: Individual, Social, and Environmental Resources

Context

Patient characteristics are important in the liver transplant population because of proven associations between individual and environmental factors, treatment adherence, and health outcomes in general medical and other transplant populations.

Objective

To determine generalizability of the sample to other liver transplant populations and to establish reliability of measures used to assess individual and environmental resources.

Design

Cross-sectional analysis of baseline data in a longitudinal study of adherence and health outcomes.

Participants, Setting

Ninety first-time adult liver transplant recipients at the University of Pittsburgh Medical Center completed assessments of sociodemographic, health history, psychosocial, and environmental factors shortly after surgery; adherence and health outcomes were tracked throughout the study.

Results

The medical center cohort was older, less racially diverse, and contained more living donors than the national sample. Our sample was generally comparable to the medical center cohort on pretransplant sociodemographic and clinical characteristics. Reliability/internal consistency on psychological measures was similar between our sample and most published norms. The mean scores on all coping scales in our sample were higher than normative. Our patients indicated a more negative perception of family environment and perceived relationships with their primary caregiver more positively than did the normative group.

Conclusion

The generalizability of our sample to the parent population and reliability of individual and environmental measures reported here will enable us to examine relationships and the value of patient and contextual resources for predicting treatment adherence and health outcomes among liver transplant recipients.