Coby Annema1, Petrie F Roodbol1, Edwin R Van den Heuvel2, Herold J Metselaar3, Bart Van Hoek4, Robert J Porte5, Adelita V Ranchor6. 1. Department of Nursing Research, University Medical Center Groningen, University of Groningen, the Netherlands. 2. Department of Mathematics and Computer Science, Eindhoven University of Technology, the Netherlands. 3. Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, the Netherlands. 4. Department of Gastroenterology and Hepatology, Leiden University Medical Center, the Netherlands. 5. Department of Surgery, Section of Hepato-Pancreatic-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, the Netherlands. 6. Department of Health Psychology, University Medical Center Groningen, University of Groningen, the Netherlands.
Abstract
OBJECTIVES: To explore whether distinct trajectories of anxiety and depression exist among liver transplant candidates, and to gain insight into demographic, clinical, and individual characteristics related with these trajectories. DESIGN: A multicentre, prospective cohort study among 216 liver transplant candidates. Respondents filled out a questionnaire at study entrance and subsequently every 6 months until transplantation or removal from the waiting list. METHODS: Anxiety (STAI6), depression (CES-D), demographic, and individual variables were assessed by questionnaire. Clinical variables were retrieved by medical record review. The SAS PROC TRAJ procedure was used to identify distinct trajectories. Univariate and multiple ordinal logistic regression analyses were used to explore related variables. RESULTS: Regarding anxiety, three stable trajectories were identified as follows: below clinical level (51%), slightly above clinical level (34%), and high above clinical level (15%). Regarding depression, four stable trajectories were identified as follows: below clinical level (23%), slightly below clinical level (34%), slightly above clinical level (28%), and high above clinical level (6%). For anxiety as well as for depression, experiencing more liver disease symptoms, a lower level of personal control, making more use of emotional coping, and making less use of task-oriented coping increased the likelihood of membership in those trajectories with higher symptom levels. CONCLUSION: Distinct, but stable, trajectories of anxiety and depression were present in liver transplant candidates. The trajectories with symptom levels above clinical relevant levels for anxiety or depression comprised, respectively, 49% and 34% of the respondents. Therefore, psychological screening and subsequently providing appropriate interventions are warranted early in the transplant process. Statement of contribution What is already known on this subject For transplant candidates, the waiting-list period is a period of uncertainty and unpredictability. Psychological problems, such as anxiety and depression, are common among liver transplant candidates. Several demographic, clinical, and individual characteristics are associated with anxiety and depression, but these results remain inconclusive. What does this study add Distinct trajectories of symptoms of anxiety and depression are present among liver transplant candidates. Given the stability of the trajectories over time, the symptom level at baseline is indicative of the symptom level during the waiting-list period. Experiencing more liver disease symptoms, low mastery, more use of emotional coping, and less use of task-oriented coping are associated with trajectories of high symptom levels.
OBJECTIVES: To explore whether distinct trajectories of anxiety and depression exist among liver transplant candidates, and to gain insight into demographic, clinical, and individual characteristics related with these trajectories. DESIGN: A multicentre, prospective cohort study among 216 liver transplant candidates. Respondents filled out a questionnaire at study entrance and subsequently every 6 months until transplantation or removal from the waiting list. METHODS:Anxiety (STAI6), depression (CES-D), demographic, and individual variables were assessed by questionnaire. Clinical variables were retrieved by medical record review. The SAS PROC TRAJ procedure was used to identify distinct trajectories. Univariate and multiple ordinal logistic regression analyses were used to explore related variables. RESULTS: Regarding anxiety, three stable trajectories were identified as follows: below clinical level (51%), slightly above clinical level (34%), and high above clinical level (15%). Regarding depression, four stable trajectories were identified as follows: below clinical level (23%), slightly below clinical level (34%), slightly above clinical level (28%), and high above clinical level (6%). For anxiety as well as for depression, experiencing more liver disease symptoms, a lower level of personal control, making more use of emotional coping, and making less use of task-oriented coping increased the likelihood of membership in those trajectories with higher symptom levels. CONCLUSION: Distinct, but stable, trajectories of anxiety and depression were present in liver transplant candidates. The trajectories with symptom levels above clinical relevant levels for anxiety or depression comprised, respectively, 49% and 34% of the respondents. Therefore, psychological screening and subsequently providing appropriate interventions are warranted early in the transplant process. Statement of contribution What is already known on this subject For transplant candidates, the waiting-list period is a period of uncertainty and unpredictability. Psychological problems, such as anxiety and depression, are common among liver transplant candidates. Several demographic, clinical, and individual characteristics are associated with anxiety and depression, but these results remain inconclusive. What does this study add Distinct trajectories of symptoms of anxiety and depression are present among liver transplant candidates. Given the stability of the trajectories over time, the symptom level at baseline is indicative of the symptom level during the waiting-list period. Experiencing more liver disease symptoms, low mastery, more use of emotional coping, and less use of task-oriented coping are associated with trajectories of high symptom levels.
Authors: Anna R Gagliardi; Cindy Y Y Yip; Jonathan Irish; Frances C Wright; Barry Rubin; Heather Ross; Robin Green; Susan Abbey; Mary Pat McAndrews; Donna E Stewart Journal: Health Expect Date: 2021-03-26 Impact factor: 3.318
Authors: Mirjam Plantinga; Lauren Zwienenberg; Eva van Dijk; Hanna Breet; Janouk Diphoorn; Julia El Mecky; Katelijne Bouman; Joke Verheij; Erwin Birnie; Adelita V Ranchor; Nicole Corsten-Janssen; Irene M van Langen Journal: Prenat Diagn Date: 2021-10-22 Impact factor: 3.242