Asgari Parvaneh, Jackson Alun C, Bahramnezhad Fatemeh
PhD Candidate in Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Australian Centre for Heart Health, Melbourne, Australia.
Iran J Nurs Midwifery Res. 2021 Mar 5;26(2):89-96. doi: 10.4103/ijnmr.IJNMR_9_20. eCollection 2021 Mar-Apr.
Although the phenomenon of adjustment to a new heart in transplant recipients is very complex, very few studies have been conducted on this important issue. Therefore, no careful and clear definition exists for this concept.
This concept analysis was conducted in Iran in 2018 on 13 patients undergoing heart transplantation. In the theoretical phase, a conceptual framework was created according to the existing data in the literature about the phenomenon. In this study, 13 participants were selected using purposive sampling with maximum diversity.-Ž In the fieldwork phase, 20 deep and semistructured interviews were conducted with patients undergoing heart transplantation over 4 months. After data saturation, interviews were analyzed using the qualitative content analysis method proposed by Granheim and Lundman (2009). At the final analytical phase, the results of the two previous phases were integrated using a hybrid model.
Adjustment to a new heart is a unique multiphase process in patients undergoing heart transplantation. The antecedents include the transplantation time, physical conditions, social and family support, relationship with congeners, and spiritual beliefs. The desirable consequences of adjustment to a new heart may include a new life, inner peace, and spiritual excellence, and the undesirable consequences may include psychological abuse and emotional stagnation.
According to the results, the health-care team should consider the patient as a unique client and initiate discussions before and following heart transplantation that address patients' adjustment to a new heart in all their physical, sexual, and emotional aspects.
尽管心脏移植受者对新心脏的适应现象非常复杂,但针对这一重要问题的研究却很少。因此,对于这一概念尚无细致且明确的定义。
2018年在伊朗对13名接受心脏移植的患者进行了此项概念分析。在理论阶段,根据文献中关于该现象的现有数据构建了一个概念框架。在本研究中,采用最大差异目的抽样法选取了13名参与者。在实地调查阶段,在4个月内对接受心脏移植的患者进行了20次深度半结构化访谈。在数据饱和后,采用格兰海姆和伦德曼(2009年)提出的定性内容分析法对访谈进行分析。在最终分析阶段,使用混合模型整合了前两个阶段的结果。
对接受心脏移植的患者而言,适应新心脏是一个独特的多阶段过程。其先决条件包括移植时间、身体状况、社会和家庭支持、与同侪的关系以及精神信仰。适应新心脏的理想结果可能包括新的生活、内心平静和精神升华,而不良后果可能包括心理虐待和情绪停滞。
根据研究结果,医疗团队应将患者视为独特个体,并在心脏移植前后展开讨论,涵盖患者在身体、性和情感等所有方面对新心脏的适应情况。