PREDICTORS OF QUALITY-OF-LIFE AND ADJUSTMENT AFTER LUNG TRANSPLANTATION

Study objective: Few studies have examined predictors of quality of li fe and adjustment after lung transplantation, This study determined wh ether pretransplant psychological measures predicted physical health, quality of life, and overall adjustment posttransplant. Cross-sectiona l analyses also examined differences in adjustment and quality of life for lung transplant candidates and recipients. Design and participant s: Seventeen transplant candidates and 60 transplant recipients comple ted questionnaires measuring adjustment and quality of life. in additi on, we examined archival data on 107 transplant candidates who had rec eived pretransplant psychological assessments, and posttransplant phys ical health status data were collected on these patients. Of the 107 p atients who provided a pretransplant psychological assessment, 32 comp leted the questionnaires measuring posttransplant adjustment and quali ty of life. Setting: University medical center transplant service. Res ults: Cross-sectional analyses indicated significantly better adjustme nt and quality of life posttransplant. Pretransplant psychological var iables were not associated with measures of posttransplant physical he alth. Hierarchical multiple regression analyses found that pretranspla nt anxiety and psychopathology predicted posttransplant adjustment (be ta's ranging from 0.32 to 0.68) and greater pretransplant anxiety also predicted worse posttransplant quality of life (beta's ranging from 0 .29 to 0.62). Subjective sleep disturbances were associated with poore r adjustment and quality of life (beta's ranging from 0.36 to 0.75), a nd were found to mediate the relationship, between, presurgical anxiet y and posttransplant adjustment and quality of life. Conclusions: This study found that psychological status pretransplant predicted adjustm ent and quality of life posttransplant. Moreover, increased anxiety le vels pretransplant predicted subsequent subjective sleep disturbances, which were, in turn, associated with poorer adjustment and quality of life. The benefits of pretransplant stress management interventions a re discussed.