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Methodist Debakey Cardiovasc J. 2016 Oct-Dec; 12(4 Suppl): 16.
PMCID: PMC5347180

Psychosocial Assessment in Renal Failure and Transplantation

Background

Goals of psychosocial screening include careful assessment and identification of potential modifiable factors that can affect successful delivery of care before, during, and after organ transplantation. Evaluation of the patient's comorbid psychiatric conditions, history of alcohol, tobacco, and other substance use, cognitive functioning, motivation, coping skills, and ability to collaborate with the transplant team and adhere to treatment recommendations provides valuable information for treatment planning.

Methods

Several screening tools have been introduced over the years in an effort to standardize the assessments, manage candidate selection bias, and establish consistency. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) can be effectively used as a standalone tool or within the context of a comprehensive assessment, with cut-off decision points reflecting the individual center's experience and transplant candidate selection threshold criteria.

Clinical Bias

Patients with complex chronic medical and comorbid psychiatric conditions represent a challenging group with higher resource utilization, an increased risk of hospital readmission, and challenges with posttransplant treatment adherence. A majority of these patients are seen in the physical outpatient setting with limited or no mental health care availability.

Conclusions

Introduction of an integrated care post-organ-transplantation model with psychosocial assessment of biological, psychological, social, and health system domains can offer unique opportunities to evaluate the individual's vulnerability and provide comprehensive quality care, timely intervention, and value-added integration of medical and mental health services.

Conflict of Interest Disclosure

The author has completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

References

1. Levenson JL, editor The American Psychiatric Publishing Textbook of Psychosomatic Medicine. First edition Arlington, VA: American Psychiatric Publishing, Inc; 2011. 1120 p.
2. Maldonado JR, Dubois HC, David EE, et al. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics. 2012. Mar-Apr; 53( 2): 123– 32. [PubMed]
3. Cartesian Solutions, Inc. [Internet]. Burnsville, MN: Cartesian Solutions, Inc.; c2016. [updated 2016 Jul 14]. Available from: http://www.cartesiansolutions.com/

Articles from Methodist DeBakey Cardiovascular Journal are provided here courtesy of Methodist DeBakey Heart & Vascular Center