The Meaning of Surviving Three Years after a Heart Transplant—A Transition from Uncertainty to Acceptance through Adaptation
Abstract
:1. Introduction
2. Patients and Methods
2.1. Data Collection
2.2. Data Analysis
2.3. Ethical Considerations
3. Results
3.1. Structural Analysis
3.1.1. Accepting Life as It Is
… and I know then he (the son) said: But why did you push the car? You should have waited. Well I said, I wanted to test myself. Because I think you must dare.//Otherwise… yes, as I said there’s no point. Should you walk around dreading what could happen?… because I mean it can, of course, anything can happen, you can be run over or something like that … but you cannot walk around dreading…//… all the time thinking about what could happen.//Because as I feel that I am living on borrowed time, well if I get ten years or twenty or thirty years, it is still a bonus.(3)
I have been thinking about working for two more years, then I’m sixty-three years old, so I wasn’t going to work to sixty-five and that… but I probably would have thought the same even if this hadn’t happened. But it has become clearer now. I might have worked 100 percent if this had not happened. But… yes, I think… obviously I’m thinking about the future, but I don’t take it for granted anymore.(11)
3.1.2. Adapting to Post-Transplant Limitations
So, I think that somehow my immune system becomes stronger as time goes by. I feel a difference between now and before…/… A year ago, I think that I was sicker and got colds more often, had tonsillitis all the time… I think my immune system is a little better now so… But I try to stay away from the kindergarten and such, I pick up the kids outdoors, so I don’t have to go inside.(12)
… I have pressure and a little pain on my left side... you usually do not have that, but I guess it is because they opened me twice, the Heartmate first and then the transplant. So, it’s probably nerve damage that causes… It hasn’t got any better, no. I have this kind of electric TENS device. It’s a little bumpy to have it and the wiring hanging on me, but I used it when I started trying to work.//Since then, I have access to lighter nerve patches that are pasted on the skin and that relieve the pain. It is instead of taking pain killers.(7)
3.1.3. Adapting to a Changed Body
… I can feel like this… in the past I had my heart… but this (my body) is after all me and the heart is not… I can… I have at some point probably said my heart but usually I say, “the heart”, as after all, it is someone else’s heart that is sitting in my body. So, I think I will never be able to feel that it is my heart… but it is still keeping me alive, so I am very grateful.(3)
Just being at work all by yourself is not too bad, it functions well. But when you must concentrate on what others say it gets pretty hard. It is better now when there is a lot of noise and stuff… which was a pain before. I’ve probably learned to just ignore it... brain fatigue, typically you hear all the sounds. I do that now too, because I hear everything that happens around here...(10)
3.1.4. Social Adaptation
… I have a new heart, am I healthy or unhealthy now? It leans more towards being unhealthy.//For example, when I was at the bank to invest money… I can’t remember exactly why but it was something about filling out a health declaration. Then you are not classified as healthy.(7)
3.1.5. Showing Gratitude
I tried to pay back, I have paid for my heart… I already paid for it in 2014 when I got the bill./But then I tried… I repaid a little… Last autumn I lectured at... the nurse association for cardiac intensive care nurses, when they had a congress here in XXX. So, I presented the patient perspective. I buzzed for two hours and there were people from all over the country.(5)
3.1.6. Trusting Oneself and Others
… every day I am filled with wonder… that it (the heart) is working. But at the same time, I also take it a little for granted./Now that it has been working for three years there is a great probability that it will work for five more years too, and so on and so on. So, every day your sense of security increases because nothing happened after all.(5)
3.2. Comprehensive Understanding
4. Discussion
4.1. Reflection on the Findings
4.2. Methodological Considerations
4.3. Implications for Practice
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Number of Participants |
---|---|
Male | 9 |
Female | 3 |
LVAD | 6 |
Dilated cardiomyopathy | 9 |
Uni ventricular heart | 1 |
ARVD/C (cardiomyopathy) | 1 |
Ischemic cardiomyopathy | 1 |
Meaning Unit | Condensation | Sub-Theme | Theme |
---|---|---|---|
“So… about a year ago, I got a whim. Then we sold our house and bought a farm down in XXX with animals and horses and everything possible there. So now I have regained my desire for life.” | Regaining zest for life | Enjoying life | Accepting life as it is |
“No, I have done that, and I have got into such good shape, so I enjoy it. But the actual time that remains. I have already used up three years, I mean… purely statistically, it does not look good… after all. It doesn’t. But, I think it is sixty-five percent that can handle ten years, I mean, that… it’s a little over fifty percent, what the… I mean I have… seven years left. If I have seven years left, I do not want to go down there (to work) Monday, Tuesday and Wednesday and feel uncomfortable with those xxx years. That’s what I think. | Thinking about the quality of the time he is statistically expected to survive | Expecting a shorter life span | Accepting life as it is |
Sub-Themes | Themes |
---|---|
Adjusting and enjoying life Living normally and fully Feeling recovered Expecting a shorter life span Doubting the future | Accepting life as it is |
Suffering from complications Adjusting or not to the lifelong medication Adjusting to the risk of infection Mastering more severe illness when infected Balancing between health and illness | Adapting to post transplant limitations |
Accepting a changed body and its limitations Keeping in good physical shape Not feeling restricted Experiencing mental fatigue and needing support Needing time to recover mentally | Adapting to a changed body |
Feeling alone Wishing for independence Being supported Reducing one’s social network Needing a social context | Social adaptation |
Feeling grateful Feeling responsible Paying back Feeling lucky | Showing gratitude |
Trusting the new heart Feeling confident Trusting the transplant professionals | Trusting oneself and others |
Main Theme One Year after Heart Transplantation: Being in Uncertainty | Main Theme Three Years after Heart Transplantation: Achieving Acceptance by Adaptation |
---|---|
Themes one year after heart transplantation (n = 14): | Themes three years after heart transplantation (n = 12) |
Doubting survival | Accepting life as it is |
Doubting the recovery process | Adapting to post transplant limitations |
Doubting one’s performance | Adapting to a changed body |
Struggling with close relationships | Social adaptation |
Feeling abandoned | Showing gratitude |
Doubting the future | Trusting oneself and others |
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Lindberg, C.; Almgren, M.; Lennerling, A.; Forsberg, A. The Meaning of Surviving Three Years after a Heart Transplant—A Transition from Uncertainty to Acceptance through Adaptation. Int. J. Environ. Res. Public Health 2020, 17, 5434. https://doi.org/10.3390/ijerph17155434
Lindberg C, Almgren M, Lennerling A, Forsberg A. The Meaning of Surviving Three Years after a Heart Transplant—A Transition from Uncertainty to Acceptance through Adaptation. International Journal of Environmental Research and Public Health. 2020; 17(15):5434. https://doi.org/10.3390/ijerph17155434
Chicago/Turabian StyleLindberg, Catharina, Matilda Almgren, Annette Lennerling, and Anna Forsberg. 2020. "The Meaning of Surviving Three Years after a Heart Transplant—A Transition from Uncertainty to Acceptance through Adaptation" International Journal of Environmental Research and Public Health 17, no. 15: 5434. https://doi.org/10.3390/ijerph17155434
APA StyleLindberg, C., Almgren, M., Lennerling, A., & Forsberg, A. (2020). The Meaning of Surviving Three Years after a Heart Transplant—A Transition from Uncertainty to Acceptance through Adaptation. International Journal of Environmental Research and Public Health, 17(15), 5434. https://doi.org/10.3390/ijerph17155434