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Parental psychosocial outcomes in pediatric liver and/or intestinal transplantation: Pretransplantation and the early postoperative period
Author(s) -
Tarbell Sally E.,
Kosmach Beverly
Publication year - 1998
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500040511
Subject(s) - psychosocial , liver transplantation , medicine , vitality , mental health , quality of life (healthcare) , population , transplantation , psychological intervention , distress , clinical psychology , psychology , psychiatry , philosophy , theology , nursing , environmental health
Although liver transplantation has become an effective treatment for end‐stage liver disease and liver/intestine transplantation is becoming an increasingly viable procedure for end‐stage short‐gut syndrome in children, little is known about the impact of these procedures on the child's family. Examination of the impact of these transplantations on the family is needed to identify psychosocial factors that may adversely affect the child's physical and emotional health and to plan for preventive interventions. The psychosocial impact of pediatric liver and/or intestine transplantation on parents was assessed in a cross‐sectional sample of 41 mothers and 20 fathers evaluated pretransplantation and 2 months posttransplantation. Parental mental health, parenting stress, and quality of life were assessed, as well as demographic, child, and family characteristics as they related to parental outcomes. Parent adjustment did not differ with regard to time of assessment. A majority of parents (n = 31) reported elevated psychological symptoms on the Brief Symptom Inventory (BSI), with fathers showing greater distress than mothers ( P < .05). Parents' total scores on the Parenting Stress Index and the Parent and Child Domain subscales were in the normal range. Quality of life was assessed by the Physical Health, General Health Perception, and Vitality subscales of the SF‐36. Parents reported better physical functioning ( P = .02) but lower vitality ratings than a normative population ( P < .01). Family conflict was associated with higher psychological distress on the BSI ( P = .02), whereas demographic factors, including the child's age, sex, and number of people in the household, proved most useful in predicting parenting stress and quality of life. These findings of significant psychological distress in parents of children undergoing liver and/or small‐intestine transplantation have implications for the child's adaptation and underscore the need for psychosocial assessment of both parents in the perioperative period. Early identification of families at psychosocial risk and the development of interventions that may prevent or reduce psychological distress are indicated to ensure the best possible outcomes for these children and their families.