TY - JOUR
T1 - Caregiver-reported outcomes of pediatric transplantation
T2 - Changes and predictors at 6 months post-transplant
AU - Cushman, Grace
AU - Gutierrez-Colina, Ana M.
AU - Lee, Jennifer L.
AU - Rich, Kristin Loiselle
AU - Mee, Laura L.
AU - Rea, Kelly
AU - Blount, Ronald L.
AU - Eaton, Cyd K.
N1 - Funding Information:
This research was generously supported by the University of Georgia's Graduate School Dissertation Completion Award, Innovative and Interdisciplinary Research Grant, Graduate School Dean's Award, and Center for Research and Engagement in Diversity (RED) Seed Grant Program; The American Psychological Association's Elizabeth Munsterberg Koppitz Fellowship; and the Transplant Services Research Fund at Children's Healthcare of Atlanta
Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/11
Y1 - 2021/11
N2 - Background: It is widely assumed that pediatric solid organ transplantation results in better caregiver-reported outcomes, including reduced caregiver psychological distress and increased child health-related quality of life (HRQOL), yet little empirical evidence of this expectation exists. The current investigation aims to fill this gap and identify key clinical course factors predictive of caregiver-reported outcomes. Methods: Forty-nine caregivers of children (Mage = 10.30 years, SD = 5.43) presenting for kidney, liver, or heart transplant evaluation reported on their psychological distress levels (anxiety, depression, somatization, and global psychological stress) and their children's HRQOL at children's pretransplant evaluations and 6 months post-transplant. Clinical course factors were abstracted via medical chart review. Results: Caregivers did not report significant changes in their psychological distress from pre- to post-transplant but reported significantly improved child HRQOL across most domains (ds = −.45 to −.54). Higher post-transplant caregiver global psychological distress was predicted by older child age, shorter time since diagnosis, and lower pretransplant caregiver-reported child HRQOL even after controlling for pretransplant caregiver psychological distress. Lower post-transplant child total HRQOL was predicted by more post-transplant hospitalizations even after controlling for pretransplant child total HRQOL. Conclusions: These preliminary results indicate pediatric solid organ transplantation was associated with some improved caregiver-reported outcomes, specifically children's HRQOL, but not caregivers’ psychological distress. Linear regression models identify several clinical course and pretransplant factors associated with transplantation outcomes. Characterizing how caregivers view their psychological distress levels and children's HRQOL across the transplantation process could inform family-centered holistic care and support caregiver adaptation to transplantation.
AB - Background: It is widely assumed that pediatric solid organ transplantation results in better caregiver-reported outcomes, including reduced caregiver psychological distress and increased child health-related quality of life (HRQOL), yet little empirical evidence of this expectation exists. The current investigation aims to fill this gap and identify key clinical course factors predictive of caregiver-reported outcomes. Methods: Forty-nine caregivers of children (Mage = 10.30 years, SD = 5.43) presenting for kidney, liver, or heart transplant evaluation reported on their psychological distress levels (anxiety, depression, somatization, and global psychological stress) and their children's HRQOL at children's pretransplant evaluations and 6 months post-transplant. Clinical course factors were abstracted via medical chart review. Results: Caregivers did not report significant changes in their psychological distress from pre- to post-transplant but reported significantly improved child HRQOL across most domains (ds = −.45 to −.54). Higher post-transplant caregiver global psychological distress was predicted by older child age, shorter time since diagnosis, and lower pretransplant caregiver-reported child HRQOL even after controlling for pretransplant caregiver psychological distress. Lower post-transplant child total HRQOL was predicted by more post-transplant hospitalizations even after controlling for pretransplant child total HRQOL. Conclusions: These preliminary results indicate pediatric solid organ transplantation was associated with some improved caregiver-reported outcomes, specifically children's HRQOL, but not caregivers’ psychological distress. Linear regression models identify several clinical course and pretransplant factors associated with transplantation outcomes. Characterizing how caregivers view their psychological distress levels and children's HRQOL across the transplantation process could inform family-centered holistic care and support caregiver adaptation to transplantation.
KW - Caregiver-reported outcomes
KW - psychological stress
KW - quality of life
KW - transplantation
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U2 - 10.1111/petr.14067
DO - 10.1111/petr.14067
M3 - Article
C2 - 34132445
AN - SCOPUS:85107932360
SN - 1397-3142
VL - 25
JO - Pediatric transplantation
JF - Pediatric transplantation
IS - 7
M1 - e14067
ER -