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(Chest. 2002;122:1176-1184.)
© 2002 American College of Chest Physicians

Effects of a Telephone-Based Psychosocial Intervention for Patients Awaiting Lung Transplantation*

Melissa A. Napolitano, PhD{dagger}; Michael A. Babyak, PhD; Scott Palmer, MD, FCCP; Victor Tapson, MD, FCCP; R. Duane Davis, MD, FCCP and James A. Blumenthal, PhD; for the INSPIRE Investigators{ddagger}

* From the Departments of Psychiatry and Behavioral Sciences (Drs. Napolitano, Babyak, and Blumenthal), Medicine (Drs. Palmer and Tapson), and Surgery (Dr. Davis), Duke University Medical Center, Durham, NC. {dagger} Currently at Brown University Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI. {ddagger} A complete list of the Investigational Study of Psychological Intervention in Recipients of Lung Transplant (INSPIRE) investigators is located in Appendix 1.

Correspondence to: James A. Blumenthal, PhD, Department of Psychiatry and Behavioral Sciences, Box 3119, Duke University Medical Center, Durham, NC 27710; e-mail: Blume003{at}mc.duke.edu

Study objectives: To test the efficacy of a tailored telephone-based intervention consisting of supportive counseling and cognitive behavioral techniques for individuals awaiting lung transplantation on measures of quality of life and general well-being.

Method: Patients were randomly assigned to either a telephone-based special intervention (SI; n = 36) for 8 weeks (average session length, 16.3 min) or a usual care (UC) control condition (n = 35) in which subjects received usual medical care but no special treatment or phone calls. At baseline, and immediately following the 8-week intervention, patients completed a psychometric test battery.

Setting: Duke University Medical Center, Pulmonary Transplantation Program.

Patients: Seventy-one patients with end-stage pulmonary disease listed for lung transplantation.

Primary outcome measures: Measures of health-related quality of life (both general and disease-specific), general psychological well-being, and social support.

Results: Multivariate analysis of covariance, adjusting for pretreatment baseline scores, age, gender, and time waiting on the transplant list, revealed that patients in the SI condition compared to the UC reported greater general well-being (p < 0.05), better general quality of life (p < 0.01), better disease-specific quality of life (p < 0.05), and higher levels of social support (p < 0.0001).

Conclusion: A brief, relatively inexpensive, telephone-based psychosocial intervention is an effective method for reducing distress and increasing health-related quality of life in patients awaiting lung transplantation.

Key Words: counseling • lung transplantation • quality of life • stress




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