The role of religion in heart-transplant recipients' long-term health and well-being.

While religion has long been recognized clinically to provide important coping strategies in the face of serious health problems, there has been little systematic consideration of its role in organ transplant recipients' long-term reactions and adjustment to this experience. This study examines these issues through qualitative and quantitative evaluation of longitudinal data collected from 40 adult heart recipients followed during their first year post-transplant. Large proportions of recipients expressed strong beliefs and were able to increase religious participation over the 12-month study period. They delineated specific ways in which their faith had provided them support, as well as ways in which the transplant experience itself further strengthened their beliefs. We found empirical evidence that recipients with strong beliefs who participated in religious activities had better physical and emotional well-being, fewer health worries, and better medical compliance by the final 12-month assessment. The findings suggest the development of specific nursing, social-service, or pastoral-involvement strategies, continuing staff education about the role of religion in patient care. The implications of such interventions for maximizing quality of life in transplant recipients are discussed.

New nephritogenic streptococcal serotypes during epidemic post-streptococcal acute glomerulonephritis - abstract

The increased incidence of reported scabies per 100,000 population from 24.2 in 1984 to 59.5 in 1985 led to a careful monitoring in 1986 of all patients with post-streptococcal acute glomerulonephritis (PSAGN). There were 18 cases of PSAGN, 72 of whom yield 84 streptococcal isolates, 65 of which belonged to group A. All streptococcal isolates were sent to the Central Public Health Laboratory Service, Colindale, England, for serotyping. The epidemic of PSAGN was bimodal, and the first phase (March to July) saw the advent of M-type 73 strain, one previously isolated 22 years ago by one of us (DCJB, unpublished data). Since then, there had been 2 subsequent isolates in 1978 and the reappearance of this strain appears to be associated with the first wave of the PSAGN epidemic. Another new strain, M-type 48, preceded the first phase of the epidemic and was isolated from 2 PSAGN patients. Provisional type (PT) 5757 had not previously been isolated in Trinidad. Seven patients yielded this strain which occurred during the first wave of the epidemic. Thus the first wave of the bimodal epidemic involved mainly the new serotypes M73, M48 and PT 5757 while the more intense second phase was associated mainly with M-type 55, a few of which also occurred during the first phase (AU)