Abstract
As more cardiac transplant procedures are performed, the psychosocial implications of the procedure can be identified and investigated. The process of cardiac transplant can be viewed as a series of stages and adaptive tasks which begin with the proposal of transplant and progress to successful postoperative adaptation.
The suggestion of transplant may evoke feelings of anxiety and ambivalence as patients realize that transplant may be their only option for long-term survival. The evaluation process determines the need for transplant and whether there are circumstances that might limit post-transplant survival. Psychosocial evaluation is important as survival depends in part on the recipient's ability to cope with stressors and comply with a complex medical regimen. This evaluation is not standardized, and research continues to identify reliable predictors of postoperative behavioral and psychiatric complications.
The wait for a donor may be the most stressful of all stages as candidates deal with increasing symptoms, increasingly intensive medical management and the fear of a donor will not be found in time. Following successful surgery, heart recipients and their families express feelings of joy and relief. During convalescence, adjustment difficulties may arise in the form of transient depression or body image concerns. After recipients are discharged from the hospital, they must comply with intensive medical follow-up to monitor their health. They continue to be vulnerable to physical, emotional and financial problems. They need to develop a realistic acceptance of life as a transplant recipient and to suppress feelings of vulnerability in order to view their future positively. Emotional support through counseling and support groups can be helpful. Increased functional capacity following cardiac transplantation is well documented, but studies pertaining to quality of life have varying results. Health professionals continue to work collaboratively to improve quality of life after cardiac transplantation.
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