Brantmark Anna, Forsberg Anna, Lennerling Annette, Herlenius Gustaf, Engström My
The Transplant Centre, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Clin Nurs. 2025 Jun;34(6):2094-2106. doi: 10.1111/jocn.17666. Epub 2025 Jan 24.
To explore the meaning of adaptation after visceral transplantation in terms of patient experiences, symptoms, self-efficacy, transplant-specific and mental well-being.
A convergent parallel mixed-methods study, consisting of interviews and generic as well as transplant-specific questionnaires. Results were integrated using meta-inference.
The study comprises a population of 17 visceral transplant recipients in Scandinavia, 12 women and 5 men with a mean age of 40.6 years (range 19-63 years) and an average follow-up of 9.4 years (range 0-25 years). Data were collected between May 2023 and January 2024 through open-ended in-depth interviews with 12 participants and analysed in accordance with phenomenological hermeneutics. Questionnaires from all 17 participants were analysed to measure transplant-specific well-being, symptoms, self-efficacy as well as anxiety and depressive symptoms.
Being a visceral transplant recipient is a dynamic and life-long adaptation process that comprises two distinct yet interconnected trajectories: coherence and endurance. Coherence involves the person's ability to make sense of their situation and find meaning despite the challenges and adversity of the chronic condition. In contrast, endurance involves a person's capacity to withstand hardship and endure unpleasant or difficult experiences. Both trajectories interact dynamically, influencing and reinforcing each other. Resilience based on coherence enabled acceptance and adjustment. Conversely, uncertainty, resignation and feeling unsupported resulted in a lack of acceptance, manifested as resistance. The challenge involved in adaptation was demonstrated by 47% showing borderline elevated or elevated levels of anxiety and 18% reporting symptoms of depression. Self-efficacy varied considerably.
The meaning of adaptation after visceral transplantation in terms of experiences, symptoms, transplant-specific and mental well-being is balancing between coherence and endurance facilitated by acceptance and hampered by resistance. The uncertainty inherent in being a visceral transplant recipient may lead to heightened self-rated anxiety symptoms and diminished self-efficacy.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: What problem did the study adress? This study adresses the challenges involved in being a visceral transplant recipient and adapting to life after a visceral transplantation. What were the main findings?
COREQ checklist (consolidated criteria for reporting qualitative research).
No Patient or Public Contribution was organised.
从患者经历、症状、自我效能感、移植特异性及心理健康等方面探讨内脏移植后适应的意义。
一项收敛平行混合方法研究，包括访谈以及通用和移植特异性问卷。结果采用元推理进行整合。
该研究纳入了斯堪的纳维亚半岛的17名内脏移植受者，其中12名女性和5名男性，平均年龄40.6岁（范围19 - 63岁），平均随访9.4年（范围0 - 25年）。2023年5月至2024年1月期间，通过对12名参与者进行开放式深度访谈收集数据，并依据现象学诠释学进行分析。对所有17名参与者的问卷进行分析，以测量移植特异性幸福感、症状、自我效能感以及焦虑和抑郁症状。
作为内脏移植受者是一个动态的终身适应过程，包括两个不同但相互关联的轨迹：连贯性和耐力。连贯性涉及个体在面对慢性病的挑战和逆境时理解自身状况并找到意义的能力。相比之下，耐力涉及个体承受艰难困苦和忍受不愉快或困难经历的能力。这两个轨迹动态相互作用，相互影响和加强。基于连贯性的复原力促成了接纳和调整。相反，不确定性、顺从和感到缺乏支持导致缺乏接纳，表现为抗拒。47%的人焦虑水平处于临界升高或升高状态，18%的人报告有抑郁症状，这表明了适应过程中所面临的挑战。自我效能感差异很大。
在内脏移植后，从经历、症状、移植特异性及心理健康方面来看，适应的意义在于在连贯性和耐力之间取得平衡，接纳有助于这种平衡，而抗拒则会阻碍它。作为内脏移植受者所固有的不确定性可能导致自评焦虑症状加剧和自我效能感降低。
对专业和/或患者护理的启示：该研究解决了什么问题？本研究解决了作为内脏移植受者以及适应内脏移植后生活所面临的挑战。主要发现是什么？
COREQ清单（定性研究报告的统一标准）。
未组织患者或公众参与。
