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Fear of graft rejection after heart transplantation – a nationwide cross-sectional cohort study

Forsberg, Anna LU ; Kisch, Annika M. LU orcid ; Paulsson, Annika ; Ragntoft, Cecilia ; Dalvindt, Marita LU orcid and Lennerling, Annette (2021) In European Journal of Cardiovascular Nursing 20(1). p.71-79
Abstract

Background: Cellular rejection is most common 3–6 months after heart transplantation while chronic rejection, that is, cardiac allograft vasculopathy and malignancy are the most common causes of death in heart-transplant recipients beyond the third year after transplantation. However, the heart transplantation recipient’s perceived threat of graft rejection has never been explored. Aim: The aim was to explore perceived threat of the risk of graft rejection and its relationship to psychological wellbeing, fatigue, health literacy, adherence and self-efficacy 1–5 years after heart transplantation. Methods: In a nationwide, cross-sectional study that constituted part of the Self-management after thoracic transplantation project, 79 heart... (More)

Background: Cellular rejection is most common 3–6 months after heart transplantation while chronic rejection, that is, cardiac allograft vasculopathy and malignancy are the most common causes of death in heart-transplant recipients beyond the third year after transplantation. However, the heart transplantation recipient’s perceived threat of graft rejection has never been explored. Aim: The aim was to explore perceived threat of the risk of graft rejection and its relationship to psychological wellbeing, fatigue, health literacy, adherence and self-efficacy 1–5 years after heart transplantation. Methods: In a nationwide, cross-sectional study that constituted part of the Self-management after thoracic transplantation project, 79 heart recipients (68% men and 32% women with a mean age of 52.6 years) were investigated after one year (n=28), two years (n=17), three years (n=11), four years (n=17) and five years (n=6). The instruments used were: the Perceived Threat of the Risk of Graft Rejection, the Psychological General Well-being, Self-efficacy for Managing Chronic Disease, the Multidimensional Fatigue Inventory, the Newest Vital Sign and the Basel Assessment of Adherence to Immunosuppressive Medication Scale. Results: Twenty-eight per cent of the heart transplantation recipients perceived graft rejection as a serious threat. Intrusive anxiety was low and 37% perceived the threat of the risk of graft rejection as being beyond their control. Heart transplant recipients with high level of fatigue and low psychological well-being reported stronger intrusive anxiety and less control. Conclusion: A perceived threat of the risk of graft rejection is present in the everyday lives of heart transplantation recipients and is strongly related to overall psychological well-being.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
graft rejection, Heart transplantation, psychological wellbeing, self-efficacy
in
European Journal of Cardiovascular Nursing
volume
20
issue
1
pages
71 - 79
publisher
Oxford University Press
external identifiers
  • pmid:32638625
  • scopus:85087722783
ISSN
1474-5151
DOI
10.1177/1474515120937838
project
Symptom distress and symptom management after heart transplantation
language
English
LU publication?
yes
id
07398076-2f19-49ee-8afd-e0025273a2bd
date added to LUP
2020-07-23 10:47:41
date last changed
2025-04-04 15:30:30
@article{07398076-2f19-49ee-8afd-e0025273a2bd,
  abstract     = {{<p>Background: Cellular rejection is most common 3–6 months after heart transplantation while chronic rejection, that is, cardiac allograft vasculopathy and malignancy are the most common causes of death in heart-transplant recipients beyond the third year after transplantation. However, the heart transplantation recipient’s perceived threat of graft rejection has never been explored. Aim: The aim was to explore perceived threat of the risk of graft rejection and its relationship to psychological wellbeing, fatigue, health literacy, adherence and self-efficacy 1–5 years after heart transplantation. Methods: In a nationwide, cross-sectional study that constituted part of the Self-management after thoracic transplantation project, 79 heart recipients (68% men and 32% women with a mean age of 52.6 years) were investigated after one year (n=28), two years (n=17), three years (n=11), four years (n=17) and five years (n=6). The instruments used were: the Perceived Threat of the Risk of Graft Rejection, the Psychological General Well-being, Self-efficacy for Managing Chronic Disease, the Multidimensional Fatigue Inventory, the Newest Vital Sign and the Basel Assessment of Adherence to Immunosuppressive Medication Scale. Results: Twenty-eight per cent of the heart transplantation recipients perceived graft rejection as a serious threat. Intrusive anxiety was low and 37% perceived the threat of the risk of graft rejection as being beyond their control. Heart transplant recipients with high level of fatigue and low psychological well-being reported stronger intrusive anxiety and less control. Conclusion: A perceived threat of the risk of graft rejection is present in the everyday lives of heart transplantation recipients and is strongly related to overall psychological well-being.</p>}},
  author       = {{Forsberg, Anna and Kisch, Annika M. and Paulsson, Annika and Ragntoft, Cecilia and Dalvindt, Marita and Lennerling, Annette}},
  issn         = {{1474-5151}},
  keywords     = {{graft rejection; Heart transplantation; psychological wellbeing; self-efficacy}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{71--79}},
  publisher    = {{Oxford University Press}},
  series       = {{European Journal of Cardiovascular Nursing}},
  title        = {{Fear of graft rejection after heart transplantation – a nationwide cross-sectional cohort study}},
  url          = {{http://dx.doi.org/10.1177/1474515120937838}},
  doi          = {{10.1177/1474515120937838}},
  volume       = {{20}},
  year         = {{2021}},
}