Improved care in pulmonary arterial hypertension has led to increased longevity for patients, with a paralleled evolution in the nature of their needs. There is more focus on the impact of the disease on their day-to-day activities and quality of life, and a holistic approach is coming to the front of pulmonary arterial hypertension management, which places the patient at the centre of their own healthcare. Patients are thus becoming more proactive, involved and engaged in their self-care, and this engagement is an important factor if patient outcomes are to improve. In addition, involvement of the patient may improve their ability to cope with pulmonary arterial hypertension, as well as help them to become effective in the self-management of their disease. Successful patient engagement can be achieved through effective education and the delivery and communication of timely, high-quality information. A multidisciplinary approach involving healthcare professionals, carers, patient associations and expert patient programmes can also encourage patients to engage. Strategies that promote patient engagement can help to achieve the best possible care and support for the patient and also benefit healthcare providers.

The patients are troubled by both physical and psychological challenges after lung transplantation. Several areas call for interventions from healthcare professionals during the early post-transplant period.

The recovery process after lung transplantation is very demanding and challenging in different ways. The patients need to re-learn their new body physically and mentally. Physically the patients must be aware of the signs, reactions and physical capacity of the body. Mentally the patients must face a new mindset. The guidelines for life after lung transplantation are complex and comprehensive; however, assistance in self-monitoring and self-management is useful (DeVito et al., 2016). Particularly, self-management improves health outcomes after a lung transplantation (Kugler et al., 2010;