Kelly M Pennington1,2, Roberto P Benzo1, Terry D Schneekloth3,4, Marie Budev5, Satish Chandrashekaran6, David B Erasmus7, Erika D Lease8, Deborah J Levine9, Karin Thompson1, Elizabeth Stevens1, Paul J Novotny10, Cassie C Kennedy1,2,4. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic Rochester, MN, USA. 2. Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic Rochester, MN, USA. 3. Department of Psychiatry and Psychology, Mayo Clinic Rochester, MN, USA. 4. William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic Rochester, MN, USA. 5. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cleveland Clinic Foundation Cleveland, OH, USA. 6. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. 7. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic Jacksonville, FL, USA. 8. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington Seattle, WA, USA. 9. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Texas Health Sciences Center San Antonio, TX, USA. 10. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: We examined the association of adult lung transplant candidates' self-reported affect with transplant-related outcomes, evaluating whether a positive (vs negative) frame of mind might be protective. METHOD: Consenting waitlisted candidates from 6 centers completed the questionnaires including the Positive and Negative Affect Schedule annually and posttransplant. Univariate logistic regression analysis was performed to determine the association of baseline affect with outcomes of death or delisting. Models were subsequently adjusted for age, marital status, and education. RESULTS: Questionnaires were completed by 169 candidates (77.9% participation). Mean positive affect, negative affect, and positive-to-negative affect ratio (positivity ratio) were similar to expected norms. The scores of the questionnaire did not change significantly over time. Fifteen (8.9%) waitlisted participants died. Candidates who died while waiting had lower positivity ratios compared to those who survived (1.82 vs 2.45; P = .02). A more negative affect was associated with increased death on the waiting list (adjusted odds ratio [OR] 1.10; P = .021). Conversely, a higher positivity ratio was associated with decreased death while waiting (adjusted OR: 0.45; P = .027). CONCLUSION: Negative affect may represent a novel risk factor for death on the waitlist. Enhancing positive affect may represent a useful target for psychological optimization in lung transplant candidates.
BACKGROUND: We examined the association of adult lung transplant candidates' self-reported affect with transplant-related outcomes, evaluating whether a positive (vs negative) frame of mind might be protective. METHOD: Consenting waitlisted candidates from 6 centers completed the questionnaires including the Positive and Negative Affect Schedule annually and posttransplant. Univariate logistic regression analysis was performed to determine the association of baseline affect with outcomes of death or delisting. Models were subsequently adjusted for age, marital status, and education. RESULTS: Questionnaires were completed by 169 candidates (77.9% participation). Mean positive affect, negative affect, and positive-to-negative affect ratio (positivity ratio) were similar to expected norms. The scores of the questionnaire did not change significantly over time. Fifteen (8.9%) waitlisted participantsdied. Candidates who died while waiting had lower positivity ratios compared to those who survived (1.82 vs 2.45; P = .02). A more negative affect was associated with increased death on the waiting list (adjusted odds ratio [OR] 1.10; P = .021). Conversely, a higher positivity ratio was associated with decreased death while waiting (adjusted OR: 0.45; P = .027). CONCLUSION: Negative affect may represent a novel risk factor for death on the waitlist. Enhancing positive affect may represent a useful target for psychological optimization in lung transplant candidates.
Entities:
Keywords:
affect; emotional well-being; lung transplant; positive and negative affect schedule (PANAS); transplant waiting list
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