Browsing by Subject "thoracic transplant"

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    Advocating for the Role of Occupational Therapy in the Transplant Continuum of Care
    (2024-05) Koppen, Arianna; Hess, Pamela; Department of Occupational Therapy, School of Health and Human Sciences; DiPerna, Christy; Bernard, Drew
    The thoracic transplant continuum of care includes lung transplant, heart transplant, and ventricular assistive devices (VAD) candidates and recipients. This patient population often faces unique physical, cognitive, psychosocial, and mental health deficits that impair physical and occupational performance hindering activities of daily living (ADLs). Survey and observational data (n=24) was collected from clinicians and patients participating in a transplant-specific rehabilitation program in Indianapolis, IN to identify occupational performance deficits and define the need for occupational therapy in this setting. Recommendations for integrating occupational therapy into the clinic were developed and included in the report.
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    Interitem Psychometric Validation of the Stanford Integrated Assessment for Transplant Scale Among Thoracic Transplant Candidates
    (Elsevier, 2023-09) Teh, Lisa; Henderson, Danielle; Hage, Chadi; Chernyak, Yelena; Psychiatry, School of Medicine
    Background Psychosocial evaluations are mandatory for transplant listing, however the methodology for creating psychosocial risk stratifications is unclear. The Standford Psychosocial Integrated Psychosocial Assessment for Transplant Scale is the most commonly used instrument, however its interitem validity has never been examined. Objective To investigate the interitem validity of a psychosocial assessment tool for transplant candidates among a sample of thoracic transplant candidates. Methods Clinic data consisting of Stanford Integrated Psychosocial Assessment for Transplant administrations from 173 heart and lung transplant candidates were fit to a partial credit model. Data were subsequently fit to 4 separate partial credit models based on subscale categories, demonstrating the discrimination parameter estimate of each item. Differential item functioning analyses were conducted on the data within each subscale by sex to investigate potential bias produced by each item. Results The initial partial credit model using the full scale did not converge, indicating the subscales possibly did not measure the same underlying construct. Subscale discrimination parameter estimates demonstrated that most items were adequately or highly discriminative. The item measuring history of substance use demonstrated poor fit and differential item functioning. Conclusions While the Stanford Integrated Psychosocial Assessment for Transplant has demonstrated strong potential as a standardized framework for psychosocial assessments in transplant, this study identified some areas for improvement in the scoring system. The subscale scores appeared to show greater construct validity when utilized individually than when aggregated to form a total score. The substance use/abuse/dependence item did not fit well into its respective subscale. Future studies should aim to optimize the scoring system and re-asses its construct validity to improve its accuracy in discriminating between high-risk candidates and those needing psychosocial assistance.