Institute of Health Sciences, Lund University, Sweden.
Department of Thoracic surgery, Skåne University Hospital, Lund, Sweden.
Eur J Cardiovasc Nurs. 2021 Jan 1;20(1):71-79. doi: 10.1177/1474515120937838.
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.
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.
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.
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.
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.
心脏移植后 3-6 个月最常见的是细胞排斥反应，而慢性排斥反应，即心脏移植后第三年以后心脏移植物血管病和恶性肿瘤是心脏移植受者死亡的最常见原因。然而，心脏移植受者对移植物排斥的感知威胁从未被探索过。
旨在探讨心脏移植后 1-5 年感知的移植物排斥风险及其与心理健康、疲劳、健康素养、依从性和自我效能感的关系。
在一项全国性的、横断面的研究中，该研究构成了胸部移植后自我管理项目的一部分，对 79 名心脏受者（68%为男性，32%为女性，平均年龄为 52.6 岁）进行了调查，分别在 1 年后（n=28）、2 年后（n=17）、3 年后（n=11）、4 年后（n=17）和 5 年后（n=6）。使用的仪器包括：移植物排斥风险感知威胁量表、心理总体幸福感量表、慢性疾病管理自我效能感量表、多维疲劳量表、最新生命体征量表和巴塞尔免疫抑制药物依从性评估量表。
28%的心脏移植受者认为移植物排斥是一种严重的威胁。侵入性焦虑程度较低，37%的人认为移植物排斥的风险威胁超出了他们的控制范围。疲劳程度高、心理健康水平低的心脏移植受者报告说，侵入性焦虑更强，控制感更低。
心脏移植受者日常生活中存在移植物排斥风险感知威胁，与整体心理健康密切相关。
