General Psychosocial Issues In Transplantation

Patient, Family Evaluations

Why do some patients come to transplant and many others who meet medical criteria do not? The selection process includes such factors as primary physician awareness, patient knowledge base and motivation, health status, family and friends, managed care companies and geographical location. When we encounter patients on the transplant service, they, on some level, have cleared some of these hurdles. Much of the selection process has happened before patients come for their first transplant clinic evaluation. This is important to realize, as much of our job is to create a supportive and therapeutic environment to get patients through not only the medical challenges, but also psychosocial challenges of transplant. What often makes the challenge of supporting patients more difficult is the geographic distances to transplant centers, managed care concerns that have the potential of fracturing care and the need for communication between multiple medical services. It must be kept in mind the maze of tests, medical people and often frustrating systems that patients undergoing transplant are interfacing. Although this is burdensome to patients, this process has the potential for building good therapeutic alliances between patient/institutions and it provides an observation

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