Department of Health Sciences at Lund University, Lund, Sweden.
The Transplant Centre, Sahlgrenska University Hospital, Gothenburg, Sweden.
Scand J Caring Sci. 2021 Dec;35(4):1301-1308. doi: 10.1111/scs.12951. Epub 2020 Dec 28.
Recovery after heart transplantation is challenging and many heart recipients struggle with various transplant-related symptoms, side-effects of immunosuppressive medications and mental challenges. Fatigue has been reported to be one of the most common and distressing symptoms after heart transplantation and might therefore constitute a barrier to self-efficacy, which acts as a moderator of self-management.
To explore the prevalence of fatigue and its relationship to self-efficacy among heart recipients 1-5 years after transplantation.
An explorative cross-sectional design, including 79 heart recipients due for follow-up 1-5 years after transplantation. Three different self-assessment instruments were employed; The Multidimensional Fatigue Inventory-19, Self-efficacy for managing chronic disease 6-Item Scale and The Postoperative Recovery Profile.
The study was approved by the Regional Ethics Board of Lund (Dnr. 2014/670-14/10) with supplementary approval from the Swedish Ethical Review Authority (Dnr. 2019-02769).
The reported levels of fatigue for the whole group were moderate in all dimensions of the Multidimensional Fatigue Inventory-19, with highest ratings in the General Fatigue sub-scale. Those most fatigued were the groups younger than 50 years; pretransplant treatment with Mechanical Circulatory Support; not recovered or had not returned to work. Self-efficacy was associated with the sub-dimensions Mental Fatigue (ρ = -0·.649) and Reduced Motivation (ρ = -0·617), which explained 40·1% of the variance when controlled for age and gender.
The small sample size constitutes a limitation.
The moderate levels of fatigue reported indicate that it is not a widespread problem. However, for those suffering from severe fatigue it is a troublesome symptom that affects the recovery process and their ability to return to work. Efforts should be made to identify those troubled by fatigue to enable sufficient self-management support.
心脏移植后的恢复具有挑战性，许多心脏接受者在各种与移植相关的症状、免疫抑制药物的副作用和精神挑战方面挣扎。疲劳据报道是心脏移植后最常见和最痛苦的症状之一，因此可能成为自我效能的障碍，而自我效能是自我管理的调节因素。
探讨心脏移植后 1-5 年患者的疲劳发生率及其与自我效能的关系。
采用探索性横断面设计，纳入 79 名心脏移植后 1-5 年随访的患者。采用三种不同的自我评估工具；多维疲劳量表-19 项、慢性疾病管理自我效能 6 项量表和术后恢复概况。
该研究得到了隆德地区伦理委员会的批准（编号 2014/670-14/10），并得到了瑞典伦理审查局的补充批准（编号 2019-02769）。
整个组的疲劳报告水平在多维疲劳量表-19 的所有维度均为中度，在一般疲劳子量表中评分最高。最疲劳的人群是年龄小于 50 岁的人群；移植前接受机械循环支持治疗；未康复或未返回工作岗位。自我效能与心理疲劳（ρ=-.649）和降低的动力（ρ=-.617）的子维度相关，当控制年龄和性别时，解释了 40.1%的方差。
样本量小是一个限制。
报告的中度疲劳水平表明这不是一个普遍的问题。然而，对于那些患有严重疲劳的患者来说，这是一个麻烦的症状，会影响他们的恢复过程和重返工作岗位的能力。应该努力识别那些受疲劳困扰的患者，以便提供足够的自我管理支持。
