Uncertainty and Communication Preferences Among Patients Undergoing Lung Transplant Evaluation: A Mixed-Methods Study

Area of Science:

• Medical Social Sciences
• Health Communication
• Transplant Surgery

Background:

• Uncertainty in illness negatively affects quality of life.
• Clinician communication about the future is a key factor influencing patient uncertainty.
• Lung transplant evaluation involves significant future uncertainty for patients.

Purpose of the Study:

• To explore how patients undergoing lung transplant evaluation experience uncertainty.
• To investigate clinician communication regarding future expectations in lung transplant evaluations.
• To understand patient needs and preferences for information about their future.

Main Methods:

• Convergent parallel mixed-methods study combining cross-sectional surveys and semistructured interviews.
• Utilized the Mishel Uncertainty in Illness Scale-Adult (MUIS-A) to quantify uncertainty levels.
• Content analysis of interviews to identify key themes in patient experiences.

Main Results:

• Most patients (86%) worried about future quality of life, with 74% reporting uncertainty hindered planning.
• Key concerns included changing family roles (76% importance, 31% discussed).
• Interviews revealed themes of distressing uncertainty, desire for practical information, and varied communication preferences.

Conclusions:

• Patients undergoing lung transplant evaluation experience significant, distressing uncertainty.
• Important communication topics regarding future life impacts were often not addressed by clinicians.
• Clinicians should proactively discuss the implications of chronic lung disease and transplant, supporting patients in coping with uncertainty.