Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives
BackgroundThe impact of patient-specific psychosocial factors on functional outcomes after upper-extremity (UE) vascularized composite allotransplantation (VCA) is poorly understood. The objective of this study was to identify relevant psychosocial predictors for success or failure of UE VCA in an A...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1092725/full |
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| author | Nikolas R. Hummel Kevin J. Zuo Simon Talbot Zoe E. Zimmerman Jeffrey N. Katz Sarah E. Kinsley Martin Kumnig |
| author_facet | Nikolas R. Hummel Kevin J. Zuo Simon Talbot Zoe E. Zimmerman Jeffrey N. Katz Sarah E. Kinsley Martin Kumnig |
| author_sort | Nikolas R. Hummel |
| collection | DOAJ |
| description | BackgroundThe impact of patient-specific psychosocial factors on functional outcomes after upper-extremity (UE) vascularized composite allotransplantation (VCA) is poorly understood. The objective of this study was to identify relevant psychosocial predictors for success or failure of UE VCA in an Austrian cohort.MethodsA qualitative study was undertaken consisting of semi-structured interviews with UE VCA staff, transplanted patients, and close relatives. Participants were asked about their perceptions of factors that either favored or hindered a successful transplant outcome, including functional status before surgery, preparation for transplant, decision-making, rehabilitation and functional outcome after surgery, and family and social support. Interviews were conducted online and recorded with the consent of interviewees.ResultsFour bilateral UE VCA patients, 7 healthcare professionals, and a sister of a patient participated in the study. Thematic analysis revealed the importance of an expert interdisciplinary team with adequate resources for patient selection. Psychosocial aspects of prospective candidates are crucial to evaluate as they contribute to success. Both patients and providers may be impacted by public perceptions of UE VCA. Functional outcomes are optimized with a life-long commitment to rehabilitation as well as close, ongoing provider involvement.ConclusionPsychosocial factors are important elements in the assessment and follow-up care for UE VCA. To best capture psychosocial elements of care, protocols must be individualized, patient-centered, and interdisciplinary. Investigating psychosocial predictors and collecting outcomes is, thus, critical to justifying UE VCA as a medical intervention and to providing accurate and salient information to prospective candidates. |
| first_indexed | 2024-04-10T16:23:47Z |
| format | Article |
| id | doaj.art-a91f03293abc482d89424cb16af84e44 |
| institution | Directory Open Access Journal |
| issn | 1664-1078 |
| language | English |
| last_indexed | 2024-04-10T16:23:47Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj.art-a91f03293abc482d89424cb16af84e442023-02-09T10:32:07ZengFrontiers Media S.A.Frontiers in Psychology1664-10782023-02-011410.3389/fpsyg.2023.10927251092725Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relativesNikolas R. Hummel0Kevin J. Zuo1Simon Talbot2Zoe E. Zimmerman3Jeffrey N. Katz4Sarah E. Kinsley5Martin Kumnig6Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Center for Advanced Psychology in Plastic and Transplant Surgery, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Orthopaedic Surgery, Division of Hand and Upper Extremity Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United StatesDivision of Plastic Surgery, Brigham and Women’s Hospital, Boston, MA, United StatesDivision of Plastic Surgery, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, United StatesDivision of Plastic Surgery, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Center for Advanced Psychology in Plastic and Transplant Surgery, Medical University of Innsbruck, Innsbruck, AustriaBackgroundThe impact of patient-specific psychosocial factors on functional outcomes after upper-extremity (UE) vascularized composite allotransplantation (VCA) is poorly understood. The objective of this study was to identify relevant psychosocial predictors for success or failure of UE VCA in an Austrian cohort.MethodsA qualitative study was undertaken consisting of semi-structured interviews with UE VCA staff, transplanted patients, and close relatives. Participants were asked about their perceptions of factors that either favored or hindered a successful transplant outcome, including functional status before surgery, preparation for transplant, decision-making, rehabilitation and functional outcome after surgery, and family and social support. Interviews were conducted online and recorded with the consent of interviewees.ResultsFour bilateral UE VCA patients, 7 healthcare professionals, and a sister of a patient participated in the study. Thematic analysis revealed the importance of an expert interdisciplinary team with adequate resources for patient selection. Psychosocial aspects of prospective candidates are crucial to evaluate as they contribute to success. Both patients and providers may be impacted by public perceptions of UE VCA. Functional outcomes are optimized with a life-long commitment to rehabilitation as well as close, ongoing provider involvement.ConclusionPsychosocial factors are important elements in the assessment and follow-up care for UE VCA. To best capture psychosocial elements of care, protocols must be individualized, patient-centered, and interdisciplinary. Investigating psychosocial predictors and collecting outcomes is, thus, critical to justifying UE VCA as a medical intervention and to providing accurate and salient information to prospective candidates.https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1092725/fullvascularized composite allotransplantationqualitative researchpsychosocial predictorspsychosocial outcomesquality of life |
| spellingShingle | Nikolas R. Hummel Kevin J. Zuo Simon Talbot Zoe E. Zimmerman Jeffrey N. Katz Sarah E. Kinsley Martin Kumnig Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives Frontiers in Psychology vascularized composite allotransplantation qualitative research psychosocial predictors psychosocial outcomes quality of life |
| title | Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives |
| title_full | Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives |
| title_fullStr | Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives |
| title_full_unstemmed | Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives |
| title_short | Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives |
| title_sort | psychosocial predictors in upper extremity vascularized composite allotransplantation a qualitative study of multidimensional experiences including patients healthcare professionals and close relatives |
| topic | vascularized composite allotransplantation qualitative research psychosocial predictors psychosocial outcomes quality of life |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1092725/full |
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