Successful organizational change requires substantial efforts from both the leaders and recipients of change. After a long tradition of focusing on change leaders, academics now increasingly focus on the role of change recipients. The current literature on recipients, however, offers mostly binary categorizations of their roles in change (e.g., supportive vs. unsupportive) obtained from questionnaires. Such an approach does not reveal how events can cause shifts in recipients’ role taking during a change initiative. Actors’ roles change and are changed by change events. We adopted an assisted sensemaking approach using a narrative methodology to study recipients’ various storylines by which they construct and reconstruct their own multiple roles throughout change. Eighty participants were asked to tell the retrospective story of their experience of, and role taking in, a top-down change initiative as if they were crafting chapters of a book. Analysis and classification of these individual stories yielded five underlying composite narratives, each representing typical shifts in perceived role taking by recipients during a change initiative. This study highlights and illustrates how recipients’ role taking is a complex, adaptive, and social process.
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Little is known about the extent to which transplant recipients face emotional problems with the receipt of a transplanted organ. The Transplant Effects Questionnaire (TxEQ) enables the quantification of these problems. This study evaluates the psychometric properties of the Dutch translation of the TxEQ (TxEQ-NL) in a group of liver transplant recipients. Confirmatory factor analyses of the TxEQ-NL revealed an adequate fit with the original version. However, four items showed factor loadings <.40. Internal consistency was acceptable (.66-.79). The small correlations between the TxEQ-NL and generic measures of psychological functioning indicated that the constructs measured are related but distinguishable. Therefore, the TxEQ-NL adds a new dimension to the measurement of psychological functioning of transplant recipients.
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BACKGROUND: Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally.OBJECTIVE: The study aims were to analyze the longitudinal change in 6-minute walking distance and to identify factors contributing to this change.DESIGN: This was a longitudinal historical cohort study.METHODS: Data from patients who received a lung transplantation between March 2003 and March 2013 were analyzed for the change in 6-minute walking distance and contributing factors at screening, discharge, and 6 and 12 months after transplantation. Linear mixed-model and logistic regression analyses were performed with data on characteristics of patients, diagnosis, waiting list time, length of hospital stay, rejection, lung function, and peripheral muscle strength.RESULTS: Data from 108 recipients were included. Factors predicting 6-minute walking distance were measurement moment, diagnosis, sex, quadriceps muscle and grip strength, forced expiratory volume in 1 second (percentage of predicted), and length of hospital stay. After transplantation, 6-minute walking distance increased considerably. This initial increase was not continued between 6 and 12 months. At 12 months after lung transplantation, 58.3% of recipients did not reach the cutoff point of 82% of the predicted 6-minute walking distance. Logistic regression demonstrated that discharge values for forced expiratory volume in 1 second and quadriceps or grip strength were predictive for reaching this criterion.LIMITATIONS: Study limitations included lack of knowledge on the course of disease during the waiting list period, type and frequency of physical therapy after transplantation, and number of missing data points.CONCLUSIONS: Peripheral muscle strength predicted 6-minute walking distance; this finding suggests that quadriceps strength training should be included in physical training to increase functional exercise capacity. Attention should be paid to further increasing 6-minute walking distance between 6 and 12 months after transplantation.
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