Organ Scarcity and the Psychological Pre—Heart Transplant Evaluation: A Simulation Study Using Community Residents

Abstract

Context Although research examining medical outcomes in heart transplantation has progressed, there are few studies examining the impact of organ scarcity and wait list demand on the transplant candidate evaluation process. Objective To examine the influence of transplant knowledge pertaining to organ scarcity and wait list demand on simulated ratings of psychological distress provided by community residents participating in a simulated pre–heart transplant evaluation. Design A randomized, controlled design. We used a vignette simulation to experimentally manipulate the effect of transplant knowledge pertaining to organ scarcity in a group of community residents with no previous knowledge or experience with the transplant selection process. Participants One hundred forty-three community residents visiting a department of motor vehicles office in north central Florida were recruited. Community residents were randomly assigned to 1 of 2 experimental conditions, with either mention (n = 66) or no mention (n = 77) of organ scarcity and wait list demand statistics in their assigned vignette. Participants then served as actors and completed measures of psychological distress as part of a mock psychological pre–heart transplant evaluation. Results Participants with mention of organ scarcity reported significantly fewer symptoms of anxiety and depression compared to those with no mention of organ scarcity. This relationship remained significant even after controlling for relevant covariates, including age and simulated ratings of social desirability. Conclusion Transplant knowledge pertaining to organ scarcity and wait list demand may influence transplant candidates to report fewer symptoms of psychological distress. Clinical suggestions for dealing with underreporting of psychological distress are discussed.