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The psychological assessment of candidates for reconstructive hand transplantation

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Abstract:

Summary

Standardized psychological assessment of candidates for reconstructive hand transplantation (RHT) is a new approach in transplantation medicine. Currently, international guidelines and standardized criteria for the evaluation are not established. Patients suffering from the loss of a hand or an upper extremity have to cope with multiple challenges. For a selected group of patients, RHT represents an option for restoring natural function and for regaining daily living independence. The identification of at‐risk patients and those requiring ongoing counseling due to poor coping or limited psychological resources are the primary focus of the psychological assessment. We have developed the ‘Innsbruck Psychological Screening Program for Reconstructive Transplantation (iRT‐PSP)’ which utilizes a semi‐structured interview and standardized psychological screening procedures and continuous follow‐up ratings. Between January 2011 and October 2011, four candidates were evaluated using the iRT‐PSP. Psychological impairments including social withdrawal, embarrassment, reduced self‐esteem, and a depressive coping style were identified and poor quality of life was reported. The motivation for transplantation was diverse, depending on many factors such as bi‐ or unilateral impairment, native or accidental loss of hand, and social integration.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1432-2277.2012.01463.x

Affiliations: 1:  Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria 2:  Psychiatry, Mayo Graduate School of Medicine, Mayo Clinic, Rochester, MN, USA 3:  Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Innsbruck, Austria 4:  Department of Plastic and Reconstructive Surgery, Innsbruck Medical University, Innsbruck, Austria 5:  Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA 6:  Department of Traumatology, Innsbruck Medical University, Innsbruck, Austria 7:    Department of Radiology, Innsbruck Medical University, Innsbruck, Austria 8:  Department of Dermatology and Venerology, Innsbruck Medical University, Innsbruck, Austria 9:  Department of Pathology, Innsbruck Medical University, Innsbruck, Austria

Publication date: May 1, 2012

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