Symptom Distress Before and After Heart Transplantation – A Longitudinal 5‐Year Follow‐Up

Abstract

IntroductionSymptom distress after heart transplantation (HTx) is a significant problem causing uncertainty, low self‐efficacy, and psychological distress. Few studies have addressed self‐reported symptoms. The aim was to explore self‐reported symptom distress from time on the waiting list to 5 years after HTx and its association with self‐reported psychological well‐being, chronic pain, and fatigue in order to identify possible predictors of psychological or transplant specific well‐being.MethodsThis multicenter, longitudinal cohort study includes 48 heart recipients (HTRs), 12 women, and 36 men, with a median age of 57 years followed from pretransplant to 5 years post‐transplant. Symptom distress was explored by means of four instruments measuring psychological general wellbeing, transplant specific wellbeing, pain, and fatigue.ResultsTransplant specific well‐being for the whole improved in a stepwise manner during the first 5 years compared to pretransplant. Heart transplant recipients with poor psychological wellbeing were significantly more burdened by symptom distress, in particular sleep problems and fatigue, for up to 5 years after HTx, and their transplant‐specific well‐being never improved compared to baseline. The prevalence of pain varied from 40% to 60% and explained a significant proportion of the variance in transplant‐specific well‐being, while psychological general well‐being was mainly predicted by overall symptom distress.ConclusionThe presence of distressing symptoms explains a significant proportion of poor psychological wellbeing both among HTRs reporting chronic pain and those without pain.