Factors associated with stress and coping at 5 and 10 years after heart transplantation

Abstract

Background Heart transplant-related stressors and coping are related to poor outcomes early after transplant. The purposes of our study were to (1) identify the most frequent and bothersome stressors and most used and effective coping strategies, and (2) compare the most frequent and bothersome stresses and most used and effective coping styles between patients at 5 and 10 years after heart transplantation. We also examined differences in coping styles by patient characteristics, and factors associated with frequency and intensity of stress at both 5 and 10 years after heart transplantation. Methods This report is a secondary analysis of data from a prospective, multi-site study of quality of life outcomes. Data are from 199 and 98 patients at 5 and 10 years after transplant, respectively. Patients completed the Heart Transplant Stressor Scale and Jalowiec Coping Scale. Statistical analyses included frequencies, measures of central tendency, t-tests, Chi-square and generalized linear models. Results At 5 and 10 years after heart transplantation, the most bothersome stressors were regarding work, school, and financial issues. Patients who were 10 years post transplant reported less stress, similar stress intensity, and less use and perceived effectiveness of negative coping than patients who were 5 years post transplant. Long-term after transplant, demographic characteristics, psychological problems, negative coping, and clinical factors were related to stress frequency and/or intensity. Conclusions Heart transplant-related stress occurs long-term after surgery. Types of transplant-related stress and factors related to stress confirm the importance of ongoing psychological and clinical support after heart transplantation.

“Price to Pay for Being Alive”: Coping with the Post-Operative Demands in Heart Transplantation

“…These findings are consistent with findings in the literature that the coping ability of a patient is influenced by several factors, including: personality, specific significance of the illness phase, previous illness experiences, available external support (Heim & Willi, 1986;Kessler et al, 1985;Grady et al, 2013;Grady et al, 2016).…”

“…achievement criteria of coping may be quite different, even conflicting, depending upon the point of view adopted. (Heim & Willi 1986;Salomon et al, 2013;Davis & Brekke, 2014;Grady et al, 2013;Grady, Andrei, Li, Rybarczyk, White-Williams, Gordon, & McGee, 2016) The role of coping in influencing the outcome The outcome, namely the way recipients appraised their heart transplant experience post-operatively, found to be depended very much on how these patients coped with the various demands that accompanied the post-transplantation period. What was found to be of great importance in this study was that the selection of available coping strategies very much depended on how patients appraised the problems and on other factors that were present at the time of the selection of a particular coping strategy.…”

Repercussões no cotidiano dos pacientes pós-transplante cardíaco

“…The work of a multidisciplinary team is crucial in this matter to assist patients in their adjustment to the new life. (4,5) The daily living of those submitted to transplantation is different from that of people who have not undergone the procedure, because of the excessive care required to prevent infection, the healthy and proper food demanded, weight maintenance and continuous administration of medication sharply on time. Thus, the participation of the team in health promotion measures is of special importance, (4) as this care is effectively required and has strong social impact on the lives of those submitted to transplantation.…”

“…However, few studies, mainly at national level, approach this phenomenon, showing the need for promoting research on this topic. (5)(6)(7)(8) A consensual point in the existing studies on heart transplantation is that life itself gives a sense to the daily living; however, complex situations and new concerns related to the condition of being a heart transplantation patient come about. In that context, the existence of social, professional and, above all, spiritual support is crucial to meet the patients' aspirations, as self-care maintenance brings positive impacts on their daily living, improving the quality of life even of those with over five years of heart transplantation.…”

“…In that context, the existence of social, professional and, above all, spiritual support is crucial to meet the patients' aspirations, as self-care maintenance brings positive impacts on their daily living, improving the quality of life even of those with over five years of heart transplantation. (5)(6)(7)(8)(9) Understanding the daily living of patients submitted to transplantation implies understanding how these people relate to the guidance provided by the health team and the heart transplantation itself. In this sense, the objective of this study is to learn the repercussions of heart transplantation on the daily living of individuals submitted to the procedure.…”