Small Bowel and Multivisceral Transplantation: Psychosocial Needs and Pediatric Psychology Interventions

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Abstract

Small bowel and multivisceral transplantation is increasingly used to treat irreversible intestinal failure among children. Children who receive these transplantations and their families are asked to implement a complex medical regimen and may present with poor psychosocial outcomes. The study presented here describes the types of psychosocial problems identified within this pediatric population and the interventions that psychologists deliver to address these psychosocial problems in the context of multidisciplinary care. Medical records, over a 5-year period, of 18 children (ages 6 months to 13 years) followed in a small bowel and multivisceral transplantation program were reviewed. The most frequently occurring presenting problems were behavioral problems and medical regimen adherence concerns. The most commonly delivered interventions by psychologists were provision of behavior management strategies, psychoeducation, and facilitation of communication between the medical team and the family. Barriers and facilitators to implementing psychosocial services in the outpatient setting are discussed. Pediatric psychologists have unique expertise that could improve the medical and psychosocial outcomes for children undergoing small bowel and multivisceral transplantation and their families.

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