PURPOSE: To study the quality of life (QOL) of heart transplant (HTX) patients (pts) from a broad physiologic/psychosocial perspective during the pre-op and 5-year post-transplant periods, in order to: (1) assess what their QOL is like at major points in the illness; (2) see how QOL changes over time; (3) identify what factors predict QOL over time; (4) examine age/gender differences in 5 QOL outcomes: survival, functional status, work ability, life satisfaction, and satisfaction with the transplant. HYPOTHESES: (1) HTX pts will improve in multiple physical/psychosocial parameters from pre-op to short-term and long-term post-HTX; (2) female and older pts will have worse QOL outcomes; (3) better QOL outcomes will be found in pts who have: less symptoms, less stress, more positive coping, more satisfying social support, less difficulty complying with the regimen, more positive perception of HTX team interventions, fewer complications, less days hospitalized, and better physiologic indices. OBJECTIVES: (1) continue to enroll new pts to increase the N for multivariate analysis for the later time periods; (2) continue to follow those pts who have not been transplanted yet due to the long wait for a hear; (3) continue to follow those pts who have been transplanted but who have not yet completed the 5-year post-HTX follow-up. Sites are Loyola U/Chicago & U of Alabama/Birmingham. Thus far, 265 pts have been enrolled in the pre-op study phase (25% died, 49% transplanted); 41 pts are in the long-term follow-up (1-5 years post-HTX). Over 1200 data booklets have been done so far. VARIABLES: survival, physical/psychosocial functional status, work ability, physiologic indices, medical history, medications, complications, symptoms, compliance, stress, coping, social support, helpfulness of HTX team interventions, life satisfaction, and satisfaction with the transplant. Analysis will consist of: hierarchical regression, MANOVA, repeated-measures MANOVA/MANOCOVA, Cox survival analysis. IMPLICATIONS: (1) documents the benefits/liabilities of HTX over the long- term; (2) identifies the trade-offs between QOL and prolonged quantity of life; (3) provides data to improve pt care; (4) identifies risk factors for worse QOL outcomes; (5) provides data to facilitate pt decisions about HTX.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001693-08
Application #
2256706
Study Section
Nursing Research Study Section (NURS)
Program Officer
Hare, Martha L
Project Start
1987-07-15
Project End
1997-06-30
Budget Start
1995-07-01
Budget End
1996-06-30
Support Year
8
Fiscal Year
1995
Total Cost
Indirect Cost
Name
Loyola University Chicago
Department
Type
Schools of Nursing
DUNS #
City
Chicago
State
IL
Country
United States
Zip Code
60660
Jalowiec, Anne; Grady, Kathleen L; White-Williams, Connie (2017) Mortality, rehospitalization, and post-transplant complications in gender-mismatched heart transplant recipients. Heart Lung 46:265-272
Jalowiec, Anne; Grady, Kathleen L; White-Williams, Connie (2016) Clinical outcomes in overweight heart transplant recipients. Heart Lung 45:298-304
Jalowiec, Anne; Grady, Kathleen L; White-Williams, Connie (2012) First-year clinical outcomes in gender-mismatched heart transplant recipients. J Cardiovasc Nurs 27:519-27
Jalowiec, Anne; Grady, Kathleen L; White-Williams, Connie (2011) Gender and age differences in symptom distress and functional disability one year after heart transplant surgery. Heart Lung 40:21-30
Jalowiec, Anne; Grady, Kathleen L; White-Williams, Connie (2006) Satisfaction with heart transplantation. Prog Cardiovasc Nurs 21:134-9
White-Williams, Connie; Jalowiec, Anne; Grady, Kathleen (2005) Who returns to work after heart transplantation? J Heart Lung Transplant 24:2255-61
Grady, K L; Jalowiec, A; White-Williams, C (1999) Predictors of quality of life in patients at one year after heart transplantation. J Heart Lung Transplant 18:202-10
Grady, K L; Jalowiec, A; White-Williams, C (1999) Preoperative psychosocial predictors of hospital length of stay after heart transplantation. J Cardiovasc Nurs 14:12-26
Grady, K L; Jalowiec, A; White-Williams, C (1998) Quality of life 6 months after heart transplantation compared with indicators of illness severity before transplantation. Am J Crit Care 7:106-16
Grady, K L; Jalowiec, A; White-Williams, C (1998) Patient compliance at one year and two years after heart transplantation. J Heart Lung Transplant 17:383-94

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