Nature of spousal supportive behaviors that influence heart transplant patient compliance.

Heart transplant patient survival is dependent on strict adherence to a specific medical regimen including medication administration, infection control, diet, and exercise. The literature suggests that transplant patients are predisposed to noncompliance by virtue of the multiple factors involved in the regimen; it also suggests that spousal support may play a significant role in assisting patients to attain the regimen goals. The purpose of this descriptive study was to determine the nature of spousal behaviors influencing compliance. The method for this study involved designing an open-ended interview guide that elicited responses from married subjects, 6 to 18 months after transplantation, regarding their perceptions of spousal support. Responses were cross-classified according to a social support typology and the four regimen domains; frequency of responses was rank ordered. Spousal behaviors identified as supportive were predominantly informational (46.66%) and tangible (38.09%) in nature; only 15.23% were emotional. The data suggest a perceived need by most subjects to receive additional instruction, guidance, and feedback from the spouse; also, there is a tendency for patients to depend on their spouses for their material needs, physical assistance, and transportation until they are more capable. The results imply that because of patient personality and behavioral changes after surgery, it may be easier for spouses to avoid emotional aspects of support; communicating with patients on a more concrete level. Implications for nursing and other health care providers lie in identifying and cultivating those spousal behaviors that serve to motivate the patient toward compliance and optimal home health care maintenance.