Adams Joanna, Evangeli Michael, Lunnon-Wood Tracy, Burch Michael
Department of Psychology, University of Bath, Bath, UK.
Pediatr Transplant. 2014 Sep;18(6):637-50. doi: 10.1111/petr.12287. Epub 2014 Jun 12.
The process of heart transplantation poses numerous challenges and adaptive tasks for paediatric patients and their families. Few studies have examined how the experience of transplant interacts with developmental transitions such as adolescence, a period of significant change, and adjustment in itself. We explored adolescent heart transplant recipients' and their parents' experience of transplant from the point at which their heart condition was diagnosed to several months after transplantation. We adopted a developmental focus, to consider how participants negotiated the tasks of adolescence in the context of their transplant experiences. A qualitative approach was used to interview five adolescent-parent dyads, who reported few post-transplant complications, and the data were analysed according to the principles of IPA. Our findings revealed transplant to be a transformative experience, with two themes marking a contrast between pre- and post-transplant states: "Restriction and Dependence" and "Autonomy and Freedom." The themes are considered in relation to adolescent development. We propose that clinicians working with paediatric heart transplant recipients and their families need to consider the particular developmental challenges faced by adolescent patients and view the attainment of developmental milestones alongside physical and psychological markers of successful adjustment.
心脏移植过程给儿科患者及其家庭带来了诸多挑战和适应性任务。很少有研究探讨移植经历如何与青春期等发育转变相互作用，青春期是一个发生重大变化且本身就需要适应的时期。我们从心脏状况被诊断之时到移植后数月，探究了青少年心脏移植受者及其父母的移植经历。我们采用了发展视角，以考虑参与者在移植经历背景下如何应对青春期的任务。采用质性研究方法对五对青少年 - 父母二元组进行访谈，他们报告的移植后并发症较少，并根据诠释现象学分析（IPA）原则对数据进行了分析。我们的研究结果表明移植是一种变革性经历，有两个主题标志着移植前后状态的对比：“限制与依赖”和“自主与自由”。这些主题结合青少年发育情况进行了考量。我们建议，与儿科心脏移植受者及其家庭打交道的临床医生需要考虑青少年患者所面临的特殊发育挑战，并将达到发育里程碑与成功适应的身体和心理指标一并看待。
