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Psychological functioning, nonadherence and health outcomes after pediatric liver transplantation.
Fredericks, E M; Lopez, M J; Magee, J C; Shieck, V; Opipari-Arrigan, L.
Afiliação
  • Fredericks EM; Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA. emfred@med.umich.edu
Am J Transplant ; 7(8): 1974-83, 2007 Aug.
Article em En | MEDLINE | ID: mdl-17617862
The present study empirically assessed the relationships between adherence behaviors and HRQOL, parent and child psychological functioning and family functioning, and investigated the relationship between adherence behaviors and health outcomes in children who were within 5 years of their liver transplantation. Participants included 38 children (mean = 8.5 years, range 28 months to 16 years) and their parent/guardian(s). HRQOL and psychological functioning were examined using well-validated assessment measures. Measures of adherence included the rate of clinic attendance and standard deviations (SDs) of consecutive tacrolimus blood levels, which were collected and evaluated retrospectively. Measures of child health status included the frequency of hospital admissions, liver biopsies, episodes of rejection and graft function for the year prior to study participation. Results indicated that nonadherence was related to lower physical HRQOL, more limitations in social and school activities related to emotional and behavioral problems, parental emotional distress and decreased family cohesion. Nonadherence was also related to frequency and duration of hospitalizations, liver biopsies and rejection episodes. These results suggest that empirically based assessment of HRQOL, parenting stress and family functioning may help identify patients at risk for nonadherence, and may allow for the need-based delivery of appropriate clinical interventions.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Comportamento Infantil / Nível de Saúde / Recusa do Paciente ao Tratamento / Transplante de Fígado Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Am J Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Comportamento Infantil / Nível de Saúde / Recusa do Paciente ao Tratamento / Transplante de Fígado Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Am J Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Estados Unidos