Psychosocial responses of adolescent cystic fibrosis patients to lung transplantation

What psychosocial issues do adolescent cystic fibrosis (CF) patients experi ence after undergoing lung transplantation (Tx)? The aim of this study was to determine, using an ethnographic study design, the common themes and emo tional responses in post-lung transplant adolescent CF patients of the Card iothoracic Transplant Clinic at the Childrens Hospital Los Angeles. Ninetee n CF lung transplant recipients were studied (eight males, 11 females: mean age at time of transplant, 15.7 +/- 2.7 yr). The mean time interval from T x to interview was 25.4 months (range 1-58 months). Sixteen patients had li ving donor lobar lung Tx while three patients received cadaveric lungs. A s eries of 25 questions was used to assess the psychosocial impact of Tx, and a semistructured interview focused on the following five domains: lifestyl e, family functioning, social functioning, body image, and psychological fu nctioning. The major themes identified by patients included: a strong desir e to set and attain meaningful long-range goals, the need to control as man y aspects of their lives as possible while dealing with parental over-prote ctiveness, and the adjustment to a new lifestyle. Common emotional response s included manageable fear/anxiety of lung rejection and uncertainty of the future, impatience with disruptions of daily routines caused by post-trans plant medical management and its effect on the attainment of set. goals, an d frustration with parental over-protectiveness. In general, patients repor ted a positive outlook on life, with greater emphasis on sought-after goals as well as inter-personal relationships. This study demonstrates that adol escent CF transplant recipients develop long-term goals and plans for indep endence. By identifying and anticipating the emotional needs of this popula tion, health care providers call assist patients in improving the quality o f their lives from a physioiogical, as well as a psychological, viewpoint.