Annals of Philosophy.

n.s. v. 12 (1826)

Journal of Natural Philosophy, Chemistry & the Arts.

v. 3 (1800)

Journal of Natural Philosophy, Chemistry & the Arts.

v. 15 (1806)

Journal of Natural Philosophy, Chemistry & the Arts.

v. 4 (1801)

Existential questionings during the pretransplantation period: A qualitative phenomenological study

Background: Transplantation improves quality of life (kidney transplantation), and saves lives (heart, lung or liver transplantation), but few qualitative studies have explored existential questionings before transplantation. Methods: In this phenomenological qualitative study, patients registered for kidney (n¼30), liver (n¼11), lung (n¼15), or heart (n¼15) transplantation participated in a semi-structured interview. Findings: The following aspects were discussed: The dilemma of choice, the evaluation process, the endorsement of the ''good candidate's role'', the modification of objects, time and space perception, the co-existence of life and death, and the challenge of the body integrity and of the person's identity. Transplantation generates paradoxical situations, and challenges the person's life values. Discussion: Anxiety and distress may arise with awareness of existential questionings and the co-existence different worlds' life values. Transplantation further generates a broader societal and ethical debate as how to accompany existential questionings in a pragmatic medical environment.

Existential values transformation in all organ transplantation: A qualitative prospective study.

Organ transplantation offers a treatment of choice for patients suffering from end stage illnesses. The aim of this IRB approved prospective qualitative study was to analyze patients’ psychological concerns from their inclusion on the waiting list for first organ transplantation (TX) (T1; N=71; kidney, K=30; liver, Li=11; lung, Lu=15; heart, H=15) and six months after TX (T2; N=49; K=15; Li=10; Lu=14; H=10). Semi-structured interviews were conducted at home or in a place selected by patients. Qualitative pattern analysis (QUAPA) of the verbatim transcriptions was applied. T1 (K) Patients maintained an apparent normality (87%), building emotional protection (23%), and developing a fatalist attitude towards life (43%). (Li) Physical limits were set to spare energy until TX (73%). Illness led to reevaluation of life values (66%). (Lu) Physical and psychological self-protection was prioritized when health declined (67%). Modified life values, fatalism (33%) and spirituality (27 %) were mentioned. (H) Patients husbanded physical (80%) and psychological (67%) resources and self-protection. Modified life values and fatalist attitude towards life were reported (40%). T2 (K) New perspective on life was described, with increase of empathy towards others (20%). (Li) Positive identity and life values modifications (60%), greater openness towards others, closeness to significant ones (30%) and a more self-centered attitude (30%) prioritizing the essential (20%) were reported. Lack of respect of life values generated anger (40%). (Lu) Setting existential priorities and increase in spirituality (64%), along with the development of new life values, greater openness to others (57%) and closeness to significant ones (21%) were underlined. Lack of respect of human values induced negative feelings (36%). Self-centered attitudes, setting limits to other people were mentioned (29%). (H) Change in life values with setting life priorities was reported (70%) with increase in spirituality, and the lack of respect of life values generated anger (50%). Self-centered attitudes were reported (60%). TX not only comes with positive physical benefits, but also with positive existential values and psychological transformation, and the development of a more altruistic attitude and humanistic values.