[Relationship between Stress and Resources in Patients Waiting for Organ Transplantation: Comparison of Patients with Renal and Liver Insufficiency].

Introduction: Patients on the waiting list for organ transplantation are exposed to different stress factors and use individual resources for coping. The present study examines these factors in the context of health-related quality of life in different patient groups (patients with renal vs. liver insufficiency) and attachment pattern. Material & Methods: The following variables were measured by questionnaire in a clinical sample of 103 patients waiting for a liver or kidney transplant in Thuringia: Physical complaints (GBB), Depression and Anxiety (HADS-D), -Coping (EFK), Self-efficacy expectations (SWE), Resilience (RS-13), Social support (F-SozU-K-14), Health-related quality of life (SF-8) and Attachment style (BFPE). Results: Patients with liver insufficiency have a higher level of anxiety and show more often an insecure attachment style as renal failure patients. Differences between secure and insecure attached patients waiting for a kidney transplant are found in physical complaints, depression, depressive coping and self-efficacy, resilience, social support, active coping and mental health, in favor of secure attachment. Insecure attachment in patients with liver insufficiency leads to a less frequent usage of active coping strategies. Furthermore, the variables anxiety, depression, resilience, social support and dysfunctional coping mediate the relationship between attachment and mental health completely. Discussion: Results suggest that psychological interventions should specifically consider the variables anxiety, depression, resilience, self-efficacy, social support, coping and attachment. Conclusion: The gained insights of this study make it possible to derive implications for interventions to reduce risk factors for the development of co-morbid mental disorders and to strengthen protective factors and thus improve the well-being and quality of life of patients.