ABSTRACT
A qualitative review was conducted to define the term psychosocial as applied to transplant patients and to summarize evidence regarding the role and impact of psychosocial assessments and outcomes across the transplant process. English-language case series and empirical studies from January 1970 through April 1990 that were abstracted in Medline and Psychological Abstracts or listed in publications' bibliographies were used as data sources. A qualitative analysis was performed to determine the depth of the case reports and whether the empirical reports obtained statistically reliable, clinically significant findings. The authors conclude that psychosocial assessments differ in content and application to candidate selection depending on the transplant program. Psychosocial status before transplant does not consistently affect medical outcomes after transplant. Psychosocial status generally improves with transplant, although difficulties are prevalent in psychological adjustment and in compliance with medical regimens. Psychiatric history can predict psychological outcomes after transplant but does not consistently predict compliance. Social supports and coping strategies strengthen psychosocial outcomes. Posttransplant psychosocial outcomes may predict physical morbidity and mortality.
Subject(s)
Organ Transplantation/psychology , Organ Transplantation/rehabilitation , Outcome Assessment, Health Care , Social Support , Humans , Patient Satisfaction , Quality of LifeABSTRACT
Cryptosporidium is the leading cause of waterborne disease in the United States. Cryptosporidiosis occurs as a result of this pathogen and is potentially fatal to the immunosuppressed population. Current water treatment standards will not eradicate the pathogen, resulting in a potential public health hazard. Congress recently passed legislation addressing cryptosporidium, and health policies are pending approval with strong support from the Centers for Disease Control. The implication for community health nursing is that nurses should take on expanded roles as social, political, and economic advocates and educators to support community actions to eradicate this pathogen.
