Application of the Validated Social Assessment Instrument for Liver Transplantation Candidates.

The use of appropriate instruments for social assessment in health aims at both the participation of the subject and effectiveness in resolving demands. The objective of this study was to characterize the population assessed by the Validated Social Assessment Instrument and its implications; a descriptive, documental study with participant and dialectical observation. The data survey were taken from the social assessments applied from July 2020 to June 2021 in a transplant center in northwestern São Paulo state in Brazil. Descriptive statistics were performed. The 65 social evaluations of candidates for liver transplantation (LTx) have presented the following sociodemographic characteristics: male sex (n = 47; 72.3%); mean age of 55.05 years (range: 24-75 years old); with a partner (n = 50; 76.9%); low education level (n = 30; 46.2%); and coming from the state of São Paulo (n = 54; 83.1). Of those evaluated, 48 candidates (74%) were professionally inactive and 37 (56.9%) received assistance or social security benefits; 62 (95.4%) had a family caregiver; 61 (93.9%) had a resolutive compliance family response; 57 (87.7%) had facilitated accessibility; 59 (90.8%) met satisfactory housing standards; and 60 (92.3%) had full acceptance for LTx. The 65 candidates' (100%) social opinions were favorable, and 21 (32.3%) had some limitations and required further assistance. All of them received basic and specific social orientations, and 25 (38.5%) required social referrals. The variables have allowed a view at the totality of the social being in addition to widening the subject's participation in order to identify the real demands and facilitate the monitoring of actions, thus contributing for favorable conditions for treatment.

Burden, Stress, and Depression in Informal Caregivers of Patients Pre and Post Liver Transplant.

BACKGROUND: Caring for a patient with chronic liver disease involves exposure to factors that increase family caregivers' vulnerability to developing mental disorders. This study reassessed the scores of burden, stress, and depression in informal (family) caregivers of patients with liver disease after liver transplant. METHODS: In this observational and descriptive study, the caregivers were reassessed for the same outcomes 4 to 10 years following the initial assessment pre-transplant. The data were obtained from the identification card, the interview script, the Brazilian version of the Caregiver Burden Scale, the Lipp Inventory of Stress Symptoms for Adults, and the Beck Depression Inventory. Descriptive statistics of pre- and post-liver transplant phases were calculated, and the Wilcoxon signed rank test was used to compare the burden scores. RESULTS: The 5 caregivers were women, with a mean age of 51.6 (SD, 8.38) years. All of the caregivers' (100%) burden score increased, 2 caregivers needed to seek some form of help, and 3 caregivers showed an indication of burden risk. Regarding stress symptoms, 3 caregivers (60%) maintained a score indicating no stress, 2 caregivers (40%) presented increased scores, and the predominant symptoms changed from psychological to physical. Regarding depression, 3 caregivers (60%) maintained the minimum level of symptoms for depression, and 2 caregivers (40%) presented increased scores. CONCLUSION: After liver transplant, caregivers' burden scores increased, and levels of stress and depression increased for caregivers who already showed symptoms in the pre-transplant phase.

Validation of the Adapted Social Assessment Instrument for Liver Transplantation Candidates.

BACKGROUND AND AIMS: Assessment is considered a duty, as well as a part of the tasks of social workers; in addition, they have an ethical commitment to improve their working tools. This study aimed at validating the Adapted Social Assessment Instrument used in a transplant center in the state of São Paulo, Brazil, for liver transplantation candidates, requiring its improvement and strengthening. METHODS: The methodology was based on both Marxian dialectics and the method of content validation. The content validation analysis was performed by 5 social workers from 3 Brazilian transplant centers. They evaluated the 5 domains of the instrument: identification, socio-demographic profile, eligibility criteria, evaluation, and social interventions. Descriptive statistics of data were performed, and qualitative analysis was associated to the participant observation. RESULTS: The 5 professionals (100%) assigned the scores 3 and 4, which have demonstrated clarity, relevance, and feasibility, pointing out suggestions for improvement, some of which were considered. CONCLUSIONS: The instrument was evaluated with an approval percentage of above 80%; therefore, the instrument is a valid measure.