Adjustment to a New Heart: Concept Analysis Using a Hybrid Model
Abstract
Background: Although the phenomenon of adjustment to a new heart in transplant recipients is very complex, very few studies have been conducted on this important issue. Therefore, no careful and clear definition exists for this concept.
Materials and Methods: This concept analysis was conducted in Iran in 2018 on 13 patients undergoing heart transplantation. In the theoretical phase, a conceptual framework was created according to the existing data in the literature about the phenomenon. In this study, 13 participants were selected using purposive sampling with maximum diversity. In the fieldwork phase, 20 deep and semistructured interviews were conducted with patients undergoing heart transplantation over 4 months. After data saturation, interviews were analyzed using the qualitative content analysis method proposed by Granheim and Lundman (2009). At the final analytical phase, the results of the two previous phases were integrated using a hybrid model.
Results: Adjustment to a new heart is a unique multiphase process in patients undergoing heart transplantation. The antecedents include the transplantation time, physical conditions, social and family support, relationship with congeners, and spiritual beliefs. The desirable consequences of adjustment to a new heart may include a new life, inner peace, and spiritual excellence, and the undesirable consequences may include psychological abuse and emotional stagnation.
Conclusions: According to the results, the health‑care team should consider the patient as a unique client and initiate discussions before and following heart transplantation that address patients’ adjustment to a new heart in all their physical, sexual, and emotional aspects.
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Cavalli C, Tarzia V, Marini M, Gregori D, Casella S, Bottio T, et al. A comparison of quality of life and psychological distress in heart transplantation patients at adult and pediatric ages. Clin Transplant 2019;33:e13335.
Anthony SJ, Nicholas DB, Regehr C, West LJ. The heart as a transplanted organ: Unspoken struggles of personal identity among adolescent recipients. Can J Cardiol 2019;35:96 9.
Abbey SE, De Luca E, Mauthner OE, McKeever P, Shildrick M, Poole JM. Qualitative interviews vs standardized self report questionnaires in assessing quality of life in heart transplant recipients. J Heart Lung Transplant 2011;30:963 6.
Schneekloth TD, Hitschfeld MJ, Jowsey Gregoire SG, Petterson TM, Dunlay SM, Niazi SK, et al. Psychosocial risk predicts new episode depression after heart transplant. Psychosomatics 2019;60:47 55.
Bunzel B, Schmidl Mohl B, Grundböck A, Wollenek G. Does changing the heart mean changing personality? A retrospective inquiry on 47 heart transplant patients. Qual Life Res 1992;1:251 6.
Palackalody JD. Psychosocial journey of heart transplantation patients: A literature review. Transplant J Australasia 2019;28:16.
Frierson RL, Lippmann SB. Heart transplant patients rejected on psychiatric indications. Psychosomatics 2006;28:347 55.
Liester MB. Personality changes following heart transplantation: The role of cellular memory. Med Hypotheses 2020;135:109468. doi: 10.1016/j.mehy. 2019.109468.
Almgren M, Lennerling A, Lundmark M, Forsberg A. The meaning of being in uncertainty after heart transplantation– an unrevealed source to distress. Eur J Cardiovasc Nurs 2017;16:167 74.
Almgren M. Uncertainty After Heart Transplantation. A New Perspective on Self Efficacy and Self Management. Lund University; 2018.
Shemesh Y, Peles‐Bortz A, Peled Y, HarZahav Y, Lavee J, Freimark D, et al. Feelings of indebtedness and guilt toward donor and immunosuppressive medication adherence among heart transplant (HT x) patients, as assessed in a cross‐sectional study with the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Clin Transplant 2017;31:e13053.
Williams A, Lester L, Bulsara C, Petterson A, Bennett K, Allen E, et al. Patient Evaluation of Emotional Comfort Experienced (PEECE): Developing and testing a measurement instrument. BMJ Open 2017;7:e012999.
Sarkar BK. Hybrid model for prediction of heart disease. Soft Computing 2020;24:1903 25.
Sacco TL, Copel LC. Compassion satisfaction: A concept analysis in nursing. InNursing forum 2018;53:76 83.
Damodaran A, Di Troia F, Visaggio CA, Austin TH, Stamp M. A comparison of static, dynamic, and hybrid analysis for malware detection. J Comput Virol Hacking Tech 2017;13:1 12.
Ni J, Chen B, Allinson NM, Ye X. A hybrid model for predicting human physical activity status from lifelogging data. Eur J Oper Res 2020;281:532 42.
Mohammadi E, Zarea K, Alteren J, Sayadi N. Care needs in the phase I of cardiac rehabilitation: A hybrid concept analysis. Nurs Midwifery Stud 2019;8:48.
Dissemination CF. Systematic reviews: CRD's guidance for undertaking reviews in healthcare. York: University of York NHS Centre for Reviews & Dissemination. 2009.
Kyngäs H, Kääriäinen M, Elo S. The trustworthiness of content analysis. In: The Application of Content Analysis in Nursing Science Research. Springer; 2020. p. 41 8.
Stolf NAG, Sadala MLA. Experiencing heart transplantation: The patients’ perspective. Braz J Cardiovasc Surg 2006;21:314 23.
Kuhn WF, Davis MH, Lippmann SB. Emotional adjustment to cardiac transplantation. Gen Hosp Psychiatry 1988;10:108 13.
Dehghan Nayeri N, Varaei S, Azizi Fini I. The outcomes of heart transplantation: A qualitative study. Nurs Midwifery Stud 2017;6:196 203.
Pearsall P, Schwartz G, Russek L. Changes in heart transplant recipients that parallel the personalities of their donors. Integr Med 2000;2:65 72.
Rybarczyk B, Grady KL, Naftel DC, Kirklin JK, White Williams C, Kobashigawa J, et al. Emotional adjustment 5 years after heart transplant: A multisite study. Rehabil Psychol 2007;52:206.
Raiesdana N, Peyrovi H, Mehrdad N. Spiritual experience in heart transplant recipients in Ira. Cardiovasc Nurs J 2013;2:44 53.
Inspector Y, Kutz I, Daniel D. Another person’s heart: Magical and rational thinking in the psychological adaptation to heart transplantation. Israel J Psychiatry Relat Sci 2004;41:161 73.
Kaba E, Thompson DR, Burnard P, Edwards D, Theodosopoulou E. Somebody else’s heart inside me: A descriptive study of psychological problems after a heart transplantation. Issues Ment Health Nurs 2005;26:611 25.
Lindberg C, Almgren M, Lennerling A, Forsberg A. The meaning of surviving three years after a heart transplant—A transition from uncertainty to acceptance through adaptation. Int J Environ Res Public Health 2020;17:5434. doi: 10.3390/ ijerph 17155434.
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