Psychosocial factors, physical symptoms and physical function after lung transplantation

Relationships between psychosocial factors, physical symptoms, and physical function were explored in 50 lung transplant recipients (LTR) to determine whether psychosocial factors rendered LTR vulnerable to increased physical symptoms or functional impairment. Structured assessments were conducted to evaluate personal and family psychiatric history, post-transplant psychiatric distress (SCL-90 anxiety and depression symptoms), selfesteem, sense of mastery, and coping strategies, as well as current physical symptoms and physical functional impairment. Psychological distress, symptoms, and physical impairment were common. The percentage of cohort with each characteristic was: family (31%) and personal psychiatric histories (47%); high anxiety (39%), high depression (36%), low self-esteem (46%), low mastery (52%); low active cognitive (39%), low active behavioral (28%) and high avoidance coping (26%). Pre-transplant psychiatric history increased risk for post-transplant anxiety (r .38) and depression (r .38) and these correlated with physical symptoms (r .54-.65) and impairment (r .49-.51). Anxiety and depression exceeded non-patient norms, and lung recipients had higher depression, symptoms and impairment (p .05) than heart/lung. Low mastery correlated with high physical impairment (r .36). Mean physical impairment scores (16. 23.8) were comparable to other pulmonary populations, including transplant candidates, but were higher than other samples of LTR 3 months post-transplant. Mean physical symptom scores (16.8 5) were higher, but endorsed items were comparable to other LTR samples. Anxiety and depression correlated with symptoms and impairment and symptoms correlated with impairment (r .60). Psychosocial factors explained variance in physical symptoms (R .646) and impairment (R .545). Directions of influence between correlates need to be examined. Interventions to reduce psychological distress need to be developed.