The majority of lung transplant recipients experience improvement in the symptoms of their chronic pulmonary condition following lung transplantation, but are faced with the specter of new symptoms that invariably develop due to the devastating complications of rejection and infection. Clinicians are aware of the signs of these complications, and a plethora of studies have been published describing their incidence and impact. However, the precise characteristics and influencing factors of symptoms that cause distress, interfere with performance, or forewarn of impending complications are unknown. The purpose of this study is to describe the symptoms of acute complications after lung transplant and to identify the influencing factors. Methodological triangulation will e used to describe the symptom experience. Recipients will complete a symptom inventory and be interviewed to obtain their description of the symptoms and influencing factors they experience at intervals that coincide with evaluations for episodes of acute complications. Quantitive measures of physiological factors (pulmonary function, rejection, and infection), situational factors (time after transplant, immunosuppression regimen), and psychological factors (anxiety, depression) will be obtained at the same time intervals to determine their influence on symptomatology. Matrix analyses of qualitative and quantitative data will be performed to reveal factors that influence the symptom experience. The Theory of Unpleasant Symptoms provides a theoretical basis which nurses use to identify symptoms and their influencing factors, and design and evaluate interventions aimed at reducing the manifestations of symptoms and improving patient outcomes. Knowledge of the symptom experience of lung transplant recipients will provide the foundation for nurses to study the effects of interventions designed to detect and manage symptoms associated with acute complications after lung transplant.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31NR007425-03
Application #
6402000
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Hare, Martha L
Project Start
2001-05-15
Project End
Budget Start
2001-05-15
Budget End
2002-05-14
Support Year
3
Fiscal Year
2001
Total Cost
$29,743
Indirect Cost
Name
University of Pittsburgh
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
De Vito Dabbs, Annette; Kim, Yookyung; Vensak, Judith et al. (2004) Validation and refinement of the Questionnaire for Lung Transplant Patients. Prog Transplant 14:338-45
De Vito Dabbs, Annette; Hoffman, Leslie A; Iacono, Aldo T et al. (2004) Are symptom reports useful for differentiating between acute rejection and pulmonary infection after lung transplantation? Heart Lung 33:372-80
Dabbs, Annette De Vito; Hoffman, Leslie A; Swigart, Valerie et al. (2004) Striving for normalcy: symptoms and the threat of rejection after lung transplantation. Soc Sci Med 59:1473-84
De Vito Dabbs, Annette; Hoffman, Leslie A; Swigart, Valerie et al. (2004) Using conceptual triangulation to develop an integrated model of the symptom experience of acute rejection after lung transplantation. ANS Adv Nurs Sci 27:138-49
De Vito Dabbs, Annette; Dew, Mary Amanda; Stilley, Carol S et al. (2003) Psychosocial vulnerability, physical symptoms and physical impairment after lung and heart-lung transplantation. J Heart Lung Transplant 22:1268-75
DeVito Dabbs, Annette; Hoffman, Leslie A; Iacono, Aldo T et al. (2003) Pattern and predictors of early rejection after lung transplantation. Am J Crit Care 12:497-507
De Vito Dabbs, Annette; Hoffman, Leslie A; Dauber, James H et al. (2002) Evaluating the reliability and validity of the Questionnaire for Lung Transplant Patients. Prog Transplant 12:191-8; quiz 199-200