• Journal of Korean Clinical Nursing Research
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• v.22 no.1
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• pp.78-87
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• 2016

Purpose: This study was conducted to investigate the factors that influence the psychosocial adjustment of organ transplant recipients. Methods: Participants were 132 organ transplant recipients who received follow-up more than 3 months after the organ transplantation at one general hospital in Seoul. A questionnaire survey was done from November 3 to December 3, 2015. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and hierarchical multiple regression. Results: Family support, medical staff support and hope were significantly correlated with psychosocial adjustment. In the hierarchical multiple regression analysis, hope appeared to be the most important factor influencing psychosocial adjustment (${\beta}=.39$, p<.001). Conclusion: The findings show that hope had an influence on the psychosocial adjustment of organ transplant recipients. Thus, to improve psychosocial adjustment it is important for nurses to develop interventions to increase hope in organ transplant recipients.

• Anxiety and mood
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• v.19 no.2
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• pp.37-47
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• 2023

This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

• The Journal of Korean Academic Society of Nursing Education
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• v.6 no.2
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• pp.171-185
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• 2000

The twenty-first century may be said to be entering into a specialized qualification age to meet the needs of new technical innovations such as environmental changes, demographical changes, changes in the constitution of diseases, changes in the needs of the national health, reforms of information and knowledge, etc., which requires the provision of competitive services that can fulfill the high level needs of consumers. In consequence, it is needed to apply a practical nursing model that can serve as a guide for healthy society and to secure the sphere that can affect nursing policy-making by keeping pace with the changing environment. Furthermore, it is also urgent to expand more the activity sphere of nurse specialists with authority and autonomy, establish their legal foundation, establish a qualification accreditation system for nurse specialists, and develop educational programs. In Korea, the law relative to organ transplant past the national assembly on February 9, 2000, legally acknowledged brain death, which indicated to us the emergence of an age of organ transplant. Therefore, it necessitates to find out those of brain death from whom organ transplant is feasible in clinical practices, with their families' consent link to those terminal organ failure patients who are in need of an organ, and mediate both parties so that smooth transplant can be accomplished. A series of these complicated procedures require systematically trained specialists with high level techniques of organic management. With this in mind, this study was conducted on 69 clinical nurse specialists for organ transplant, accredited by the hospital, who are in active service in clinical practices. The resultant findings were revealed, as follows: 1. The qualifications of clinical nurse specialists for organ transplant should be accredited by Ministry of Health and Welfare or Korea Nurses Association. 2. The validity of qualifications should be for three years, and their renewal should be based on marks of a supplemental training or an education course for more than 12 hours a year. 3. The qualification of the clinical nurse specialist necessitates theoretical lectures and practices on those nurses who have had clinical experience in the pertinent field. 4. The course of training is required to be one year in the length of training and take more than 20 credits (320 hours) and 5 credits (240 hours).

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.284-293
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• 2012

Purpose: The aim of this study was to compare the levels of anxiety, depression, and quality of life (QOL) among kidney or liver transplant candidates and recipients. Methods: A cross-sectional descriptive design was utilized. The 160 subjects were recruited and assigned to three different conditions: awaiting transplant group; post-transplantation (TPL) group within less than one year of surgery; and post-TPL group with one year and no more than two years post surgery. The levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. The level of quality of life was measured by the Medical Outcomes Study Short Form-36 version 2. Results: The anxiety score was significantly higher in the waiting group compared with the 1~2 years post TPL group. The depression score was significantly higher in the waiting group compared with the post TPL groups. The QOL was significantly lower in the waiting group compared with the post TPL groups. Conclusion: Our results show a high prevalence of anxiety and depression and a marked reduction in the QOL in transplant candidates compared to the recipients. This study indicates that the group waiting for transplants may have unmet needs during that time period. Health professionals should be encouraged to attend to the psychological distress of the transplant candidates in order to improve their quality of life.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.43-49
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• 2023

In Korea, the dependence on living donations is high due to the shortage of organs available for donation compared to the number of people waiting for transplants and the number of living organ donations continues to increase. In particular, the number of living-donor transplantations is high worldwide, highlighting the importance of pre-transplant psychosocial evaluation of living kidney donors. According to previous studies, when evaluating living organ donors before transplantation, it is crucial to determine whether the donor can give informed consent and be aware of the risks after surgery. Pre-transplant evaluation tests such as ELPAT living organ donor Psychological Assessment Tool (EPAT), Live Donor Assessment Tool (LDAT), Living Donation Expectancies Questionnaire (LDEQ), Minnesota Multiphasic Personality Inventory-2 questionnaire (MMPI-2) and Temperament and Character Inventory (TCI) are conducted for donors. After reviewing the literature on these pre-transplant psychosocial assessment tools, we will also look at legal considerations for living kidney donors in Korea and suggest an effective and essential pre-transplant screening evaluation method for living kidney transplant donors.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.326.1-326.10
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• 2018

Background: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. Methods: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. Results: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. Conclusion: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.278-285
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• 2018

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

• Journal of Korean Biological Nursing Science
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• v.18 no.1
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• pp.17-26
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• 2016

Purpose: Adherence to immunosuppressants is the key to prevent organ rejection in organ transplant recipients. The purpose of this study was to investigate current interventions to improve adherence to immunosuppressants in liver transplant recipients. Methods: A systemic literature search was done using PubMed, Embase, Cochrane Library, CINAHL and four Korean databases to identify experimental studies reported in English or Korean up to and including 2015. We identified eight intervention studies on the adherence to immunosuppressants in liver transplant recipients independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed. Results: Education, conversion of regimen, and text messaging were identified as intervention techniques to improve adherence. We found positive results in three out of four studies implementing educational strategies, but the results were not sufficient to draw a definite conclusion. Conversion from a twice-daily tacrolimus-based regimen to a once-daily tacrolimus extended-release formula was used in three adult-only studies and its effectiveness was confirmed. One study showed that improved adherence and outcomes were effected by using text messaging with pediatric patients. Conclusion: Future research is needed to facilitate interventions to improve adherence to immunosuppressants in various ages of patients including pediatric/adolescent liver transplant recipients.

• Tuberculosis and Respiratory Diseases
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• v.69 no.3
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• pp.201-206
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• 2010

Nontuberculous mycobacterial (NTM) diseases are increasing worldwide. However NTM lung disease in organ transplant recipients has been rarely reported. Here, we report 2 cases of NTM lung disease in heart transplant recipients. A 37-year-old man, who had undergone a heart transplant one year previous, was admitted to hospital due to a cough. Chest CT scan showed multiple centrilobular nodules in both lower lungs. In his sputum, M. abscessus was repeatedly identified by rpoB gene analysis. The patient improved after treatment with clarithromycin, imipenem, and amikacin. An additional patient, a 53-year-old woman who had undergone a heart transplant 4 years prior and who suffered from bronchiectasis, was admitted because of purulent sputum. The patient's chest CT scan revealed aggravated bronchiectasis; M. intracellulare was isolated repeatedly in her sputum. Treatment was successfully completed with clarithromycin, ethambutol, and ciprofloxacin. NTM lung disease should be considered as a potential opportunistic infection in organ transplant recipients.

• Journal of Korean Academy of Nursing
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• v.33 no.3
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• pp.365-375
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• 2003

Purpose: This study was aimed to investigate the health related quality of life and related factors of organ transplant recipients. Method: The participants were 188 people who had liver(86), kidney(81), or heart(24) transplanted. Data on the demographic characteristics, transplantation-related characteristics, symptom frequency or discomfort measured by Transplant Symptom Frequency and Symptom Distress Scale by Lough et al(l987), and health related quality of life measured by SF-36(version 2) were collected. Result: Overall health related quality of life score was 492.1 for 100scoring and, 344.9 for norm based. Physical functioning showed the highest quality of life score (77.5) and vitality showed the lowest(51.l). The kidney transplanted showed the highest quality of life (504.4) and the heart transplanted showed the lowest(426.7) Quality of life was related with occupation(p=.016) and symtom discomfort(p < .0001). Conclusion: The health related quality of life of transplated patients was lower than the norm of American. Further studies need to be done to identify the norm of Korean and to investigate the effect of releving symptom discomfort on the increasing the health related quality of life.