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Quality of Life in Liver Transplant Recipients: The Role of the Attachment Styles
90
Abstracts
reviewed the results of a survey regarding TP teaching received from 61 US Psychiatry Residency Programs and 24 US Psychosomatic Medicine Fellowships. In order to evaluate the training program we created or adapted several instruments: 1. a pre and post- test to assess the efficacy of the lectures on TP; 2. relevant items from the ACGME Psychosomatic Milestone rubric; 3. a communication rubric to facilitate feedback regarding the communication skills; 4. a structured portfolio aimed to standardize the clinical exposure and liaison experience. Results: Our TP curriculum aims at providing the trainees with both knowledge and communication skills necessary to address the psychiatric issues in the transplantation setting. The knowledge module will consist of four lectures and clinical exposure in both inpatient and outpatient setting. The communication skills module will include three role-plays followed by actual liaison work with the transplantation team and with community mental health providers. The lectures and the role plays will be delivered in the beginning of the academic year, while the clinical experience and participation in multidisciplinary meeting will follow over the course of a 3 month rotation. The role-plays will use specific scenarios considered challenging such as recommending against transplant listing to a multidisciplinary review committee. The structured portfolio will ensure that trainees acquire a broad experience with clinical scenarios specific for TP. Conclusion: Inpatient and outpatient clinical exposure complement lectures in providing adequate knowledge in TP Liaison training may be enhanced if preceded by role play. Structured portfolio can support both knowledge and communication skills training during TP rotation. doi:10.1016/j.jpsychores.2016.03.223
98 Quality of Life in Liver Transplant Recipients: The Role of the Attachment Styles P. Zimbrean, K. Cartiera, L. Dudley, G. Babas, S. Emre Yale University, New Haven, CT, USA Background: To explore correlations between attachment styles and quality of life liver transplant recipients
Method: 182 patients who received liver transplantation at our center between 1/1/2007 and 6/20/2015 were surveyed. The questionnaire included demographic information, Relationship Style Questionnaire (RSQ), Hospital Anxiety and Depression Scale (HADS) and Short Form Health Survey (SF 36). Model 4 was used for interpretation of the RSQ. Results: 61 questionnaires were returned (response rate of 33.3%). 8 (13.1%) received combined liver-kidney transplantation. 10 (16.4%) had a living donor. 22 (36%) were within one year post transplantation.45 (73.8%) were male, 48(78.7%) were Caucasian, 20 (32.8%) had anxiety and 14 (23%) had depression on HADS. 34 (55.7%) of respondents reported a predominant dismissive attachment style (DAS), followed by 24 (39.3%) with secure attachment style (SAS). 4 (9.8%) had a preoccupied attachment style (PAS). Only 4 (6.6%) had a predominantly fearful attachment style (FAS). There were no statistically significant correlations between the attachment style and type of transplant (liver only versus combined liver-kidney), time since transplant, primary liver disease, depression or anxiety. Patients with DAS were more likely to have a history of addiction (p = 0.03), more likely to score poorly on the physical health (p = 0.02), fatigue (p = 0.04) and pain (p = 0.03). PAS correlated with lower social function (p = 0.01) and higher level of pain (p.0.007). SAS correlated with better social function post transplantation (p = 0.01). Conclusion: Secure and dismissive were the predominant attachment styles in this group of liver transplant recipients. Patients with dismissive and preoccupied attachment styles tend to have lower quality of life scores. Psychotherapeutic interventions centered on attachment styles may increase the quality of life after liver transplantation. doi:10.1016/j.jpsychores.2016.03.224
Abstracts
reviewed the results of a survey regarding TP teaching received from 61 US Psychiatry Residency Programs and 24 US Psychosomatic Medicine Fellowships. In order to evaluate the training program we created or adapted several instruments: 1. a pre and post- test to assess the efficacy of the lectures on TP; 2. relevant items from the ACGME Psychosomatic Milestone rubric; 3. a communication rubric to facilitate feedback regarding the communication skills; 4. a structured portfolio aimed to standardize the clinical exposure and liaison experience. Results: Our TP curriculum aims at providing the trainees with both knowledge and communication skills necessary to address the psychiatric issues in the transplantation setting. The knowledge module will consist of four lectures and clinical exposure in both inpatient and outpatient setting. The communication skills module will include three role-plays followed by actual liaison work with the transplantation team and with community mental health providers. The lectures and the role plays will be delivered in the beginning of the academic year, while the clinical experience and participation in multidisciplinary meeting will follow over the course of a 3 month rotation. The role-plays will use specific scenarios considered challenging such as recommending against transplant listing to a multidisciplinary review committee. The structured portfolio will ensure that trainees acquire a broad experience with clinical scenarios specific for TP. Conclusion: Inpatient and outpatient clinical exposure complement lectures in providing adequate knowledge in TP Liaison training may be enhanced if preceded by role play. Structured portfolio can support both knowledge and communication skills training during TP rotation. doi:10.1016/j.jpsychores.2016.03.223
98 Quality of Life in Liver Transplant Recipients: The Role of the Attachment Styles P. Zimbrean, K. Cartiera, L. Dudley, G. Babas, S. Emre Yale University, New Haven, CT, USA Background: To explore correlations between attachment styles and quality of life liver transplant recipients
Method: 182 patients who received liver transplantation at our center between 1/1/2007 and 6/20/2015 were surveyed. The questionnaire included demographic information, Relationship Style Questionnaire (RSQ), Hospital Anxiety and Depression Scale (HADS) and Short Form Health Survey (SF 36). Model 4 was used for interpretation of the RSQ. Results: 61 questionnaires were returned (response rate of 33.3%). 8 (13.1%) received combined liver-kidney transplantation. 10 (16.4%) had a living donor. 22 (36%) were within one year post transplantation.45 (73.8%) were male, 48(78.7%) were Caucasian, 20 (32.8%) had anxiety and 14 (23%) had depression on HADS. 34 (55.7%) of respondents reported a predominant dismissive attachment style (DAS), followed by 24 (39.3%) with secure attachment style (SAS). 4 (9.8%) had a preoccupied attachment style (PAS). Only 4 (6.6%) had a predominantly fearful attachment style (FAS). There were no statistically significant correlations between the attachment style and type of transplant (liver only versus combined liver-kidney), time since transplant, primary liver disease, depression or anxiety. Patients with DAS were more likely to have a history of addiction (p = 0.03), more likely to score poorly on the physical health (p = 0.02), fatigue (p = 0.04) and pain (p = 0.03). PAS correlated with lower social function (p = 0.01) and higher level of pain (p.0.007). SAS correlated with better social function post transplantation (p = 0.01). Conclusion: Secure and dismissive were the predominant attachment styles in this group of liver transplant recipients. Patients with dismissive and preoccupied attachment styles tend to have lower quality of life scores. Psychotherapeutic interventions centered on attachment styles may increase the quality of life after liver transplantation. doi:10.1016/j.jpsychores.2016.03.224