MO946THE LEVEL OF POST-TRAUMATIC GROWTH IN KIDNEY TRANSPLANT RECIPIENTS WITH LONG TERM DURATION OF GRAFT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Yuri Battaglia ◽  
Luigi Zerbinati ◽  
Michele Provenzano ◽  
Pasquale Esposito ◽  
Michele Andreucci ◽  
...  

Abstract Background and Aims Kidney transplant (KT)can cause a psychological trauma due to changes in self-perception, in interpersonal relationships, and in the philosophy of life. However, the exposure to this traumatic event might lead to not only stress disorders but also positive growth. Primary aim of study was to evaluate the prevalence of post-traumatic growth (PTG)in KTRs. Secondary aim was to explore any association between PTG and psychiatric, psychosocial and medical variables, specifically psychiatric diagnoses, demoralization, as well as physical and general problems or symptoms. Method KTRs followed up in a single nephrology Unit, were evaluated. Each patient was individually administered MINI International Neuropsychiatric Interview 6.0. and DCPR interview to evaluate ICD-10 psychiatric diagnoses and DCPR diagnoses. PTG Inventory (PTGI), ESAS-revised, CPC, and DS-IT were given as self-report instruments to be filled in. PTGI was used to investigate positive psychological experience of patients after KT on a 0 to 5-point Likert scale(0=I did not experience this change as a result of my KT;5=I experienced this change to a very great degree as a result of my KT).It consists of 21 items divided in five factors: New Possibilities(NP),Relating to Others(RO),Personal Strength(PS),Spiritual Change(SC),and Appreciation of Life(AL).ESAS-revised, DS-IT and CPC were used to examine the severity of physical and psychological symptoms on a 0 to 10 scale; to measure the severity of demoralization on a 0 to 4 scale and to evaluate the physical and general problems in a yes/no(0–1)format, respectively. Results Data pertaining to 134 out of 143 consecutive outpatients were collected. Clinical characteristics of sample and ranking order of ICD and DCPR diagnoses are shown in Tab.1.Mean score of PTGI total of sample was 52.02 (±20.69).SC(4.26±2.94)experience was markedly lower than RO(16.26±8.18),NP(11.25±5.56),PS(10.91±5.33)and AL(9.77±3.72).PS changes were higher in KTRs with adaption ICD diagnosis(p<0.001);while no SC change was found in KTRs with an ICD diagnosis of mood disorders(p<0.01).DCPR diagnosis of alexithymia and Irritability were associated with low RO score(13.74±6.51 and 13.97±6.95,respectively)(p <0.05).AL subscale was positively correlated with ESAS anxiety symptom and ESAS psychological distress sub-score(p<0.05); and negatively with DS-lT loss of meaning and purpose subscale(p<0.05).Women(57.2±23.07)had higher scores of PTGI than men (49.5±19.04)(p <0.05).No significant correlation was found between CPC problems, blood chemistry and socio-demographic characteristics, including months after transplant. Conclusion This study shows that KTRs had moderate-to-high levels of PTG which did not change after KT overtime. Also, lower RO score was associated with DCPR diagnosis of alexithymia, highlighting the potential ability of PTGI to identify KTRs who need psychological support. Further multicentre studies should be conducted to investigate the positive psychological changes after KT.

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i587-i588
Author(s):  
Yuri Battaglia ◽  
Giulia Piazza ◽  
Elena Martino ◽  
Sara Massarenti ◽  
Luana Peron ◽  
...  

Author(s):  
O. Tokhtamysh

This topic is particularly relevant in the context of combat operations in eastern Ukraine against the occupation of the country, where members of the combined forces operation in each day are in a situation threatening the life and risk of getting a military psychological trauma. The article considers the elements and conditions of post-traumatic growth in the context of the rehabilitation process and the social promotion of human development after a traumatic event. The phenomenon of post-traumatic growth can transform the concept of rehabilitation into a term that can be labeled as "proabilitation". The forms of social and rehabilitation support in terms of creating conditions for post-traumatic growth and their effectiveness are explored. The theoretical and applied models with resource elements of the rehabilitation process and post-traumatic growth process are analyzed. It is noted that the traditional model of posttraumatic growth pay attention to the process of rumination and getting control over it and ignores one of the basic symptom of posttraumatic stress disorder, such as uncontrolled visual images (flash backs). The two-component concept of post-traumatic growth, which may be «illusory» or «adaptive», can also be presented as a «compensatory» or «healing» type with regard to the presence or absence of post-traumatic stress disorder symptoms after reaching post-traumatic growth. Posttraumatic growth occurs in several domains and can be depending on the type of traumatic event experienced, the individual reactions and the psychological qualities of the person. This process is not such that it automatically eliminates the symptoms of post-traumatic stress disorder, the same, rejecting the need for psychotherapeutic and psychosocial care and focusing only on post-traumatic growth can be a false strategy for those who have experienced a traumatic event. Consequently, the phenomenon of post-traumatic growth can be regarded as a powerful resource factor for the rehabilitation process, in particular, as a motivational component of psychosocial assistance.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247934
Author(s):  
Younghui Hwang ◽  
Misook Kim ◽  
Kyoungok Min

Health-related quality of life (HRQOL) of kidney transplant recipients is an outcome evaluation after kidney transplants. Therefore, we investigated the associations among perceived health status, social support, self-determination, post-traumatic growth, and kidney transplant recipients’ HRQOL. This study involved a descriptive, self-report survey of 163 kidney transplant recipients visiting an outpatient solid organ transplant center in South Korea. Participants’ general and transplant characteristics, perceived health status, post-traumatic growth, social support, self-determination, and HRQOL were collected. Data were statistically analyzed using the software SPSS version 25.0. HRQOL showed statistically significant positive correlation with perceived health status (r = .56, p < .001), post-traumatic growth (r = .18, p = .022), social support (r = .25, p = .002), and self-determination (r = .36, p < .001). The factors affecting HRQOL were perceived health status (β = 0.47, p < 0.001), post-transplant occupation (β = 0.17, p = 0.009), and income source (β = -0.13, p = 0.046). The explanatory power of these variables was 34.8% (F = 28.81, p < 0.001). In the subdomains of HRQOL, the factors influencing HRQOL of mental component summary were perceived health status (β = 0.45, p < 0.001), self-determination (β = 0.27, p < 0.001), and education level (β = 0.18, p = 0.006). The explanatory power of these variables was 34.8% (F = 28.81, p < 0.001). To promote the HRQOL of kidney transplant recipients, an institutional system to assist kidney transplant recipients in returning to work needs to be developed. Additionally, creating an environment that allows kidney transplant recipients to act with self-determination, and developing intervention programs that can enhance self-determination will contribute to enhancing the HRQOL of kidney transplant recipients.


2021 ◽  
Vol 10 (20) ◽  
pp. 4747
Author(s):  
Yuri Battaglia ◽  
Luigi Zerbinati ◽  
Martino Belvederi Murri ◽  
Michele Provenzano ◽  
Pasquale Esposito ◽  
...  

Although kidney transplant can lead to psychiatric disorders, psychosocial syndromes and demoralization, a positive post-traumatic growth (PTG) can occur in kidney transplant recipients (KTRs). However, the PTG-Inventory (PTGI), a reliable tool to measure PTG is scarcely used to explore the effect of this stressful event in KTRs. Thus, the purpose of our study was to assess the level of PTG and its correlation with demoralization, physical and emotional symptoms or problems via network analysis in KTRs. Additionally, we aimed at exploring the association of PTG with psychiatric diagnoses, Diagnostic Criteria for Psychosomatic Research (DCPR) conditions, and medical variables. A total of 134 KTRs were tested using MINI International Neuropsychiatric Interview 6.0 (MINI 6.0), DCPR interview, PTGI, Edmonton Symptom Assessment System (ESAS), Canadian Problem Checklist (CPC) and Demoralization scale (DS-IT). PTGI was used to investigate the positive psychological experience of patients after KT. It consists of 21 items divided in five factors. Routine biochemistry, immunosuppressive agents, socio-demographic and clinical data were collected. A symptom network analysis was conducted among PTGI, ESAS and DS-IT. Mean score of PTGI total of sample was 52.81 ± 19.81 with higher scores in women (58.53 ± 21.57) than in men (50.04 ± 18.39) (p < 0.05). PTGI-Relating to Others (16.50 ± 7.99) sub-score was markedly higher than other PTGI factor sub-scores. KTRs with DCPR-alexithymia or International Classification of Diseases, tenth revision (ICD-10) anxiety disorders diagnosis had lower PTGI total score and higher PTGI-Personal Strength sub-score, respectively (p < 0.05). The network analysis identified two communities: PTGI and ESAS with DS-IT. DS-IT Disheartenment, DS-IT Hopelessness and PTGI Relating to Others were the most central items in the network. After 1000 bootstrap procedures, the Exploratory graph analysis revealed the presence of a median of two communities in the network in 97.5% of the bootstrap iterations. A more extensive use of PTGI should be encouraged to identify and enhance the positive psychological changes after KT.


Author(s):  
Maria Sarapultseva ◽  
Alena Zolotareva ◽  
Igor Kritsky ◽  
Natal’ya Nasretdinova ◽  
Alexey Sarapultsev

The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3–24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1–29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.


Author(s):  
M Sadeghi khorashad ◽  
E Rezaieyan ◽  
A Abdolahnezhad

Introduction: Firefighters are at high risk of developing post-traumatic stress disorder (PTSD), and that Quality of Life (QoL) is seriously compromised in individuals who have PTSD. This study was designed to assess the relationship between post-traumatic stress disorders and quality of life among firefighters. Materials and Methods: In this analytical and cross-sectional study, all firefighters in Birjand city were selected by census method (N = 96) in 2018. PTSD and QoL status was assessed by the Persian version of the Mississippi (Eshel) and WHOQOL-BREF questionnaires, respectively. Using Cronbach's α, the Iranian version of these two scales' internal reliability has been reported to be 0.92 and more than 0.7, respectively. Data analysis using SPSS software version 21 and independent T-test, ANOVA, Tukey's test, and Pearson correlation coefficient were used for statistical analysis. Results: The results showed that most firefighters (70.5%) were suffered from moderate PTSD symptoms (79.2± 11.7). Based on the self-report scale, 53.7% of the firefighters rated their quality of life as Good, and 43.2% of the firefighters were satisfied with their health. Statistical analysis showed that there is a statistically significant inverse relationship between PTSD score and areas of mental health (P = 0.03), social relations (P = 0.002), and environmental health (P = 0.004). Between PTSD score and physical health, no statistically significant relationship was found (P = 0.08). Conclusion: This study has proven a high rate of PTSD among firefighters and its negative correlation with the quality of their life. However, most firefighters rated their health and quality of life as good. Implementing strategies to combat mental disorders among firefighters improves the quality of their life and increases their job productivity.


2019 ◽  
Vol 13 ◽  
Author(s):  
Lei Zheng ◽  
Qian Lu ◽  
Yiqun Gan

AbstractExpressive writing can enhance cognitive processing and improve stress regulation. Particularly, the use of cognitive words (i.e., insightful and causal words) in writing may be associated with the process of meaning making and promotion of post-traumatic growth (PTG). The aim of the present study was to determine how expressive writing and the use of causal and insightful cognitive words influenced meaning making and PTG during writing. In total, 52 traumatized university students were recruited and randomly assigned to one of two writing conditions involving either an expressive writing task or a neutral writing task. The results showed that participants who engaged in expressive (vs. neutral) writing showed higher scores on the presence of meaning and PTG in the post-writing, self-report questionnaires. Moreover, writing task (expressive or neutral) and frequency of causal and insightful cognitive words were both significant predictors of meaning, which in turn led to high levels of PTG. In conclusion, the use of causal and insightful words might be a fundamental cognitive process for developing meaning in writing, which is essential for our further understanding of meaning making and PTG.


2020 ◽  
Vol 9 (7) ◽  
pp. 2119 ◽  
Author(s):  
Yuri Battaglia ◽  
Luigi Zerbinati ◽  
Giulia Piazza ◽  
Elena Martino ◽  
Sara Massarenti ◽  
...  

Demoralization is a commonly observed syndrome in medically ill patients. The risk of demoralization may increase in patients after a kidney transplant (KTRs) because of the stressful nature of renal transplantation, psychosocial challenges, and adjustment needs. No study is available on demoralization amongst KTRs. The purpose of our study was to evaluate the validity of the Italian version of the Demoralization Scale (DS-IT) and the prevalence of demoralization in KTRs. Also, we aimed at exploring the association of the DS-IT with International Classification of Diseases (ICD) psychiatric diagnoses, post-traumatic growth (PTG), psychological and physical symptoms, and daily-life problems. A total of 134 KTRs were administered the MINI International Neuropsychiatric Interview 6.0. and the Diagnostic Criteria for Psychosomatic Research–Demoralization (DCPR/D) Interview. The DS-IT, the Edmonton Symptom Assessment System (ESAS), the Canadian Problem Checklist (CPC), were used to measure demoralization, physical and psychological symptoms, and daily-life problems; also, positive psychological experience of kidney transplantation was assessed with the PTG Inventory. Routine biochemistry and sociodemographic data were collected. Exploratory factor analysis demonstrated a four-dimensional factor structure of the DS-IT, explaining 55% of the variance (loss of meaning and purpose, disheartenment, dysphoria, and sense of failure). DS-IT Cronbach alpha coefficients indicated good or acceptable level of internal consistency. The area under the Receiving Operating Characteristics (ROC) curve for DS-IT (against the DCPR/D interview as a gold standard) was 0.92. The DS-IT optimal cut-off points were ≥20 (sensitivity 0.87, specificity 0.82). By examining the level of demoralization, 14.2%, 46.3%, 24.6%, and 14.6% of our sample were classified as having no, low, moderate, and high demoralization, respectively, with differences according to the ICD psychiatric diagnoses (p < 0.001). DS-IT Total and subscales scores were positively correlated with scores of ESAS symptoms and CPC score. A correlation between DS-IT loss of meaning and purpose subscale and PTGI appreciation of life subscale (p < 0.05) was found. This study shows, for the first time, a satisfactory level of reliability of the DS-IT and a high prevalence of severe demoralization in KTRs.


2020 ◽  
Vol 9 (4) ◽  
pp. 995 ◽  
Author(s):  
Yuri Battaglia ◽  
Luigi Zerbinati ◽  
Giulia Piazza ◽  
Elena Martino ◽  
Michele Provenzano ◽  
...  

An average prevalence of 35% for psychiatric comorbidity has been reported in kidney transplant recipients (KTRs) and an even higher prevalence of other psychosocial syndromes, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), has also been found in this population. Consequently, an easy, simple, rapid psychiatric tool is needed to measure physical and psychological symptoms of distress in KTRs. Recently, the Edmonton Symptom Assessment System (ESAS), a pragmatic patient-centred symptom assessment tool, was validated in a single cohort of KTRs. The aims of this study were: to test the screening performances of ESAS for the International Classification of Diseases-10th Revision (ICD-10) psychiatric diagnoses in KTRs; to investigate the optimal cut-off points for ESAS physical, psychological and global subscales in detecting ICD-10 psychiatric diagnoses; and to compare ESAS scores among KTR with ICD-10 diagnosis and DCPR diagnosis. 134 KTRs were evaluated and administered the MINI International Neuropsychiatric Interview 6.0 and the DCPR Interview. The ESAS and Canadian Problem Checklist (CPC) were given as self-report instruments to be filled in and were used to examine the severity of physical and psychological symptoms and daily-life problems. The physical distress sub-score (ESAS-PHYS), psychological distress sub-score (ESAS-PSY) and global distress score (ESAS-TOT) were obtained by summing up scores of six physical symptoms, four psychological symptoms and all single ESAS symptoms, respectively. Routine biochemistry, immunosuppressive agents, socio-demographic and clinical data were collected. Receiving Operating Characteristic (ROC) analysis was used to examine the ability of the ESAS emotional distress (DT) item, ESAS-TOT, ESAS-PSY and ESAS-PHYS, to detect psychiatric cases defined by using MINI6.0. The area under the ROC curve for ESAS-TOT, ESAS-PHYS, ESAS-PSY and DT item were 0.85, 0.73, 0.89, and 0.77, respectively. The DT item, ESAS-TOT and ESAS-PSY optimal cut-off points were ≥4 (sensitivity 0.74, specificity 0.73), ≥20 (sensitivity 0.85, specificity 0.74) and ≥12 (sensitivity 0.85, specificity 0.80), respectively. No valid ESAS-PHYS cut-off was found (sensitivity <0.7, specificity <0.7). Thirty-nine (84.8%) KTRs with ICD-10 diagnosis did exceed both ESAS-TOT and ESAS-PSY cut-offs. Higher scores on the ESAS symptoms (except shortness of breath and lack of appetite) and on the CPC problems were found for ICD-10 cases and DCRP cases than for ICD-10 no-cases and DCPR no-cases. This study shows that ESAS had an optimal screening performance (84.8%) to identify ICD-10 psychiatric diagnosis, evaluated with MINI; furthermore, ESAS-TOT and ESAS-PSY cut-off points could provide a guide for clinical symptom management in KTRs.


1992 ◽  
Vol 161 (5) ◽  
pp. 658-664 ◽  
Author(s):  
Kevin Vaughan ◽  
Nicholas Tarrier

An exposure treatment for patients suffering from post-traumatic stress disorder (PTSD) is described. Image habituation training (IHT) involves the patient in generating verbal descriptions of the traumatic event and recording these onto an audiotape. After the initial training session with the therapist, homework sessions of self-directed exposure in which the patient visualised the described event in response to listening to the audiotape were carried out. Of ten consecutive patients who received this treatment, six improved considerably after ten homework sessions, two showed moderate improvements, and two showed minimal improvement on a range of outcome measures. There were significant decreases in anxiety between and within homework sessions, suggesting that habituation did occur and was responsible for improvement. Treatment gains were maintained at six-month follow-up.


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