Self-efficacy, recovery and psychological wellbeing one to five years after heart transplantation: a Swedish cross-sectional study

Abstract

Background Self-efficacy refers to a person´s confidence in carrying out treatment-related activities and constitutes the foundation of self-management as well as long-term follow-up after heart transplantation. Exploring the heart recipients´ experiences by means of self-report instruments provides healthcare professionals with valuable information on how to supply self-management support after heart transplantation. Aims The aim was to explore self-efficacy in relation to the self-reported level of recovery and psychological wellbeing, among adult heart recipients, one to 5 years after transplantation. Methods This cross-sectional study includes 79 heart recipients, due for follow-up one to 5 years after transplantation. Three different self-assessment instruments were employed: the self-efficacy for managing chronic disease 6-item scale; the postoperative recovery profile; and the psychological general wellbeing instrument. Results The reported level of self-efficacy was high (median 8.3, maximum score 10). Significantly higher self-efficacy was seen among those who had returned to work ( P = 0.003) and those without pre-transplant mechanical circulatory support ( P = 0.033). In total, 65.5% ( n = 52) reported being reasonably recovered, while 18.8% ( n = 12) were not recovered. The median total psychological general wellbeing score was 108 ( P25 = 24, P75 = 117), suggesting overall good psychological wellbeing in the whole group of heart recipients. Conclusion The heart transplant recipients in our study had an overall high level of self-efficacy. Low self-efficacy was found among those with a low self-reported level of recovery, pre-transplant treatment with mechanical circulatory support or who had not returned to work. This is important information for transplant professionals when helping heart recipients to balance their expectations about recovery.

Fatigue after heart transplantation – a possible barrier to self‐efficacy

“…Pretransplant MCS treatment seems to have impact on experiences post-transplant. It has previously been shown that HTRs who underwent MCS treatment pretransplant had lower self-efficacy than those without such treatment [33] and the present study reveals that this group also reports a higher degree of fatigue. This is an interesting and important finding, as the transplant candidates who underwent MCS were probably in better physical condition at the time of the transplantation than those without MCS.…”

Parental Disease Specific Knowledge and Its Impact on Health-Related Quality of Life

“…Readiness for discharge correlates strongly with coping at home in this study. These findings illustrate that disease-specific education for parents should target their sense of self-efficacy [ 22 ] and internal control at least as much as actual disease-related skills. In the knowledge tests, questions targeting “need to do” topics such as vaccinations, or taking of immunosuppressive education, had higher response rates than questions regarding theorectical background knowledge.…”

Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study

“…In the context of our secondary analysis, we identified 41 records from a total pool of included 742 scoping review records contained definitions. Screening of these records resulted in eight “original” definitions [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. Sixty three records were identified through secondary sources [ 20 , 21 , 23 , 25 , 26 , 28 , 30 , 31 , 33 , 34 , 35 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ,…”

“…A single definition focused on an aspect of SM medication adherence [ 44 ], and the remainder focused on all aspects. Definitions focused on one or multiple transplant organ types: heart [ 46 , 49 , 50 ], liver [ 45 , 48 , 49 ], kidney [ 44 , 45 , 49 , 51 ], pancreas [ 49 ], and lung [ 49 ] ( Supplementary File S2 ). Amongst the definition publications, seven of the eight are quantitative studies, with one qualitative [ 51 ].…”