Psychological functioning and quality of life in lung transplant candidates and recipients

Objective: The purpose of this study was to examine the psychological funct ioning and quality of life (QOL) of lung transplant candidates and recipien ts. Methods: The following measures were completed by 36 lung transplant candid ates (the pretransplant group [PRE]) and 73 recipients (the posttransplant group [POST]): the Rand-36 Item Health Survey 1.0 (RAND-36), visual analog scale of overall QOL (OQOL), Brief Symptoms Inventory (BSI), Derogatis Sexu al Functioning Inventory (DSFI), Hospital Anxiety and Depression Scale (HAD ), Rosenberg Self-Esteem Scale (RSES), and Body Cathexis Scale (BC). Results: Compared to the PRE, POST patients had significantly better scores on the following measures: RAND-36 total, physical health, role limitation s due to physical health, general health, vitality, and social functioning subscales (all p < 0.0001); visual analog scale of OQOL (p < 0.0001); BSI ( p < 0.05); BC (p < 0.05); HAD anxiety(p < 0.05) and depression (p < 0.0001) ; and RSES (p < 0.05). Despite better scores, some areas did not differ bet ween the PRE and the POST, and many patients continued to experience impair ments in psychological functioning. Specifically, the RAND-36 emotional hea lth and role limitations due to emotional health subscale scores did not di ffer between the PRE and the POST and they remained lower than published no rms. A significant proportion of patients in both groups (44% of PRE patien ts and 28% of POST patients) had borderline or clinical levels of anxiety ( ie, the HAD). Finally, PRE and POST mean scores were significantly lower th an published norms on the RSES (p < 0.05) and the body image scale of the D SFI (p < 0.05), Conclusions: Although lung transplant recipients have better general, physi cal, and psychological health than their pretransplant counterparts, the pr esent research suggests that both groups experience impairment in several a reas of psychological functioning, Future research into the QOL of the lung transplant population should be aimed at recognizing, intervening, and imp roving patients' psychological and emotional well-being.