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The feasibility of a group stress management Liver SMART intervention for patients with end-stage liver disease: A pilot study

Published online by Cambridge University Press:  04 June 2018

Devika R. Jutagir Open the ORCID record for Devika R. Jutagir [Opens in a new window] ,
Rebecca M. Saracino ,
Amy Cunningham ,
Kelly A. Foran-Tuller ,
Mary A. Driscoll ,
William H. Sledge ,
Sukru H. Emre  and
Dwain C. Fehon
Devika R. Jutagir
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT
Rebecca M. Saracino
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT
Amy Cunningham
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT
Kelly A. Foran-Tuller
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT
Mary A. Driscoll
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT
William H. Sledge
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT
Sukru H. Emre
Affiliation:
Department of Surgery, Yale School of Medicine, CT Yale-New Haven Transplantation Center, CT
Dwain C. Fehon*
Affiliation:
Department of Psychiatry, Yale School of Medicine, CT Yale-New Haven Transplantation Center, CT
*
Author for correspondence: Dwain C. Fehon, Department of Psychiatry, Yale School of Medicine, 20 York Street, Fitkin 603, New Haven, CT 06510. E-mail: dwain.fehon@yale.edu
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Abstract

Objective

Structured, empirically supported psychological interventions are lacking for patients who require organ transplantation. This stage IA psychotherapy development project developed and tested the feasibility, acceptability, tolerability, and preliminary efficacy of an 8-week group cognitive behavioral stress management intervention adapted for patients with end-stage liver disease awaiting liver transplantation.

Method

Twenty-nine English-speaking United Network for Organ Sharing–registered patients with end-stage liver disease from a single transplantation center enrolled in 8-week, group cognitive-behavioral liver stress management and relaxation training intervention adapted for patients with end-stage liver disease. Patients completed pre- and postintervention surveys that included the Beck Depression Inventory II and the Beck Anxiety Inventory. Feasibility, acceptability, tolerability, and preliminary efficacy were assessed.

Result

Attendance rate was 69.40%. The intervention was rated as “good” to “excellent” by 100% of participants who completed the postintervention survey in teaching them new skills to relax and to cope with stress, and by 94.12% of participants in helping them feel supported while waiting for a liver transplant. No adverse events were recorded over the course of treatment. Attrition was 13.79%. Anxious and depressive symptoms were not statistically different after the intervention.

Significance of results

The liver stress management and relaxation training intervention is feasible, acceptable, and tolerable to end-stage liver disease patients within a transplant clinic setting. Anxious and depressive symptoms remained stable postintervention. Randomized controlled trials are needed to study the intervention's effectiveness in this population.

Keywords

Liver transplantationpsychotherapyquality of lifepilot projectsfeasibility studies
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 1 , February 2019 , pp. 35 - 41
Copyright
Copyright © Cambridge University Press 2018 

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