43rd Italian Transplantation Society CongressKidney transplantationAnalysis of Psychopathologic Elements as a Compliance Limitation: Team Work as a Therapeutic Response
Section snippets
Material and Methods
245 visits were carried out between September 2018 and May 2019. The visits consisted of clinical interviews, targeted psychodiagnostic evaluations, graphic-projective tests, and personality and cognitive structure evaluation tests (Tree test, Draw-a-Person [DAP] test, Draw-A-Person-in-the-Rain [DAP-R] test, MMPI-2, Wartegg test, Rorschach test, Wais-IV, MMSE) [[3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]]. These assessments were key not only to defining the patient’s personality
Results
From the analysis of the tests and from the clinical and support interviews, some of the patients presented forms of psycho-emotional immaturity that impaired the predisposition to compliance and ultimately the establishment of the therapeutic alliance: lack of clear thinking, insufficient criticism and judgment, and scarce coherence in the examination of reality. The patients presented low psychological and cognitive levels, with fragile egos, using primordial defense mechanisms [18,19].
During
Discussion
Depending on the recipient’s personality characteristics, we can find several expectations that will still lead to facing the transplant’s procedures and consequences, on which it is worth dwelling to get directions on the management and organization of post-transplant events in order to define the treatment’s possibility. It should be noted that the transplant patient comes from a disabling condition of chronicity and pathology [20], conditions that may have created an experience Winnicott [21
Conclusions
This debate allowed us to highlight the importance of identifying, at an early stage, those patients who showed pathologic personality traits during the pre-transplant evaluation phase, essential key point to provide an adequate psychological-psychiatric support and follow-up.
By assessing the complexity of each patient from a medical and a psychological point of view, and by considering the high number of transplant surgeries currently occurring, it can be noted that compliance to therapy is
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