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Patients’ Early Post-Operative Experiences with Lung Transplantation: A Longitudinal Qualitative Study

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Abstract

Background and Objectives

Lung transplantation is a complex medical treatment, and for patients with end-stage lung diseases it is often the last therapeutic option available for survival. However, lung transplantation poses not only a physical but also a psychological challenge for patients. The aim of this study was to gain a deeper understanding of patients’ individual concerns related to their lung transplantation within the first 6 months post-transplant.

Methods

Forty lung transplant patients were interviewed at three different measurement timepoints post-transplant (T1: 2 weeks; T2: 3 months; and T3: 6 months) using semi-structured interviews to address their thoughts, feelings, and attitudes with respect to the transplantation process, their new lungs, and their medication. Interviews were analyzed by means of qualitative content analysis.

Results

“Physical complaints”, “fear of organ rejection”, “side effects of medication”, and “restrictions in everyday life” were the most frequently named concerns within the first 6 months post-transplant. Most themes remained unchanged over time, whereas mentions of restrictions in everyday life increased significantly over the three assessments.

Conclusions

Although the majority of the patients experienced considerable improvements in physical health after transplantation, they simultaneously reported that they were suffering from physical complaints, fear of organ rejection and infections, medication adverse effects, and restrictions in everyday life. For patients, lung transplantation therefore often means replacing one disease with another. Healthcare providers are challenged to support patients in dealing with this unresolvable dilemma.

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References

  1. Rodrigue JR, Baz MA, Kanasky WF Jr, MacNaughton KL. Does lung transplantation improve health-related quality of life? The University of Florida experience. J Heart Lung Transplant. 2005;24(6):755–63.

    Article  PubMed  Google Scholar 

  2. Kugler C, Fischer S, Gottlieb J, Tegtbur U, Welte T, Goerler H, et al. Symptom experience after lung transplantation: impact on quality of life and adherence. Clin Transplant. 2007;21(5):590–6.

    Article  PubMed  Google Scholar 

  3. Munro PE, Holland AE, Bailey M, Button BM, Snell GI. Pulmonary rehabilitation following lung transplantation. Transplant Proc. 2009;41(1):292–5.

    Article  CAS  PubMed  Google Scholar 

  4. Seiler A, Jenewein J, Martin-Soelch C, Goetzmann L, Inci I, Weder W, et al. Post-transplant outcome-clusters of psychological distress and health-related quality of life in lung transplant recipients. Swiss Med Wkly. 2015;145:w14236.

    PubMed  Google Scholar 

  5. De Vito Dabbs A, Hoffman LA, Swigart V, Happ MB, Dauber JH, McCurry KR, et al. Striving for normalcy: symptoms and the threat of rejection after lung transplantation. Soc Sci Med. 2004;59(7):1473–84.

    Article  Google Scholar 

  6. Goetzmann L, Irani S, Schwegler K, Stamm M, Bricman R, Buddeberg C, et al. Distress and alexithymia in lung recipients—psychosocial strains and associations with chronic allograft dysfunction. Swiss Med Wkly. 2010;140(25–26):382–7.

    PubMed  Google Scholar 

  7. Rosenberger EM, Dew MA, DiMartini AF, DeVito Dabbs AJ, Yusen RD. Psychosocial issues facing lung transplant candidates, recipients and family caregivers. Thorac Surg Clin. 2012;22(4):517–29.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Xu J, Adeboyejo O, Wagley E, Aubrecht J, Song MK, Thiry L, et al. Daily burdens of recipients and family caregivers after lung transplant. Prog Transplant. 2012;22(1):41–7 (quiz 48).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Finlen Copeland CA, Vock DM, Pieper K, Mark DB, Palmer SM. Impact of lung transplantation on recipient quality of life: a serial, prospective, multicenter analysis through the first posttransplant year. Chest. 2013;143(3):744–50.

    Article  PubMed  Google Scholar 

  10. Kunsebeck HW, Kugler C, Fischer S, Simon AR, Gottlieb J, Welte T, et al. Quality of life and bronchiolitis obliterans syndrome in patients after lung transplantation. Prog Transplant. 2007;17(2):136–41.

    Article  PubMed  Google Scholar 

  11. Limbos MM, Joyce DP, Chan CK, Kesten S. Psychological functioning and quality of life in lung transplant candidates and recipients. Chest. 2000;118(2):408–16.

    Article  CAS  PubMed  Google Scholar 

  12. Vermeulen KM, van der Bij W, Erasmus ME, Duiverman EJ, Koeter GH, TenVergert EM. Improved quality of life after lung transplantation in individuals with cystic fibrosis. Pediatr Pulmonol. 2004;37(5):419–26.

    Article  PubMed  Google Scholar 

  13. Seiler A, Klaghofer R, Ture M, Komossa K, Martin-Soelch C, Jenewein J. A systematic review of health-related quality of life and psychological outcomes after lung transplantation. J Heart Lung Transplant. 2016;35(2):195–202.

    Article  PubMed  Google Scholar 

  14. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483–8.

    Article  CAS  PubMed  Google Scholar 

  15. Dierckx de Casterle B, Verhaeghe ST, Kars MC, Coolbrandt A, Stevens M, Stubbe M, et al. Researching lived experience in health care: significance for care ethics. Nurs Ethics. 2011;18(2):232–42.

    Article  PubMed  Google Scholar 

  16. McKibbon KA, Gadd CS. A quantitative analysis of qualitative studies in clinical journals for the 2000 publishing year. BMC Med Inform Decis Mak. 2004;4:11.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Barbour RS. Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ. 2001;322(7294):1115–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Goetzmann L, Irani S, Moser KS, Schwegler K, Stamm M, Spindler A, et al. Psychological processing of transplantation in lung recipients: a quantitative study of organ integration and the relationship to the donor. Br J Health Psychol. 2009;14(Pt 4):667–80.

    Article  PubMed  Google Scholar 

  19. Neukom M, Corti V, Boothe B, Boehler A, Goetzmann L. Fantasized recipient-donor relationships following lung transplantations: a qualitative case analysis based on patient narratives. Int J Psychoanal. 2012;93(1):117–37.

    Article  PubMed  Google Scholar 

  20. Thomsen D, Jensen BO. Patients’ experiences of everyday life after lung transplantation. J Clin Nurs. 2009;18(24):3472–9.

    Article  PubMed  Google Scholar 

  21. Goetzmann L, Moser KS, Vetsch E, Klaghofer R, Naef R, Russi EW, et al. What do patients think after a lung transplantation about their self, lung and social network? A quantitative analysis of categorical interview data. Psychosoc Med. 2006;3:Doc03.

    PubMed  PubMed Central  Google Scholar 

  22. Ivarsson B, Ekmehag B, Sjoberg T. Patients’ experiences of information and support during the first six months after heart or lung transplantation. Eur J Cardiovasc Nurs. 2013;12(4):400–6.

    Article  PubMed  Google Scholar 

  23. Mayring P. Qualitative Inhaltsanalyse. Weinheim und Basel: Beltz Verlag; 2008.

    Google Scholar 

  24. ATLAS.ti. Software for qualitative data analysis. Berlin: ATLAS.ti; 2015.

  25. IBM Corp. IBM SPSS Statistics for Windows, Version 22.0. Armonk: IBM Corp.; 2013.

  26. Dew MA, DiMartini AF, DeVito Dabbs AJ, Fox KR, Myaskovsky L, Posluszny DM, et al. Onset and risk factors for anxiety and depression during the first 2 years after lung transplantation. Gen Hosp Psychiatry. 2012;34(2):127–38.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Goetzmann L. “Is it me, or isn’t it?”–transplanted organs and their donors as transitional objects. Am J Psychoanal. 2004;64(3):279–89.

    Article  PubMed  Google Scholar 

  28. Quintin J. Organ transplantation and meaning of life: the quest for self fulfilment. Med Health Care Philos. 2013;16(3):565–74.

    Article  PubMed  Google Scholar 

  29. De Geest S, Burkhalter H, Bogert L, Berben L, Glass TR, Denhaerynck K. Describing the evolution of medication nonadherence from pretransplant until 3 years post-transplant and determining pretransplant medication nonadherence as risk factor for post-transplant nonadherence to immunosuppressives: the Swiss Transplant Cohort Study. Transplant Int. 2014;27(7):657–66.

    Article  Google Scholar 

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Acknowledgments

The authors would like to thank the patients for their contribution. This study was made possible by grants from the Olga Mayenfisch Foundation, the Hartmann-Müller Foundation for Medical Research, and the Lunge Zürich.

Author contributions

Conception and design: Lutz Goetzann, Annette Bohler, Richard Klaghofer, Josef Jenewein.

Data acquisition: Annina Seiler, Angela Brucher, Vera Hinderling-Baertschi.

Analysis and interpretation of data: Annina Seiler, Josef Jenewein, Richard Klaghofer, Stefan Buechi.

Drafting the manuscript or revising it critically for important intellectual content: Annina Seiler, Josef Jenewein, Richard Klaghofer, Natalie Drabe, Chantal Martin-Soelch, Lutz Goetzmann, Annette Boehler, Stefan Buechi.

Final approval of the version to be published: Annina Seiler, Josef Jenewein, Richard Klaghofer, Natalie Drabe, Chantal Martin-Soelch, Vera Hinderling-Baertschi, Lutz Goetzmann, Annette Boehler, Stefan Buechi.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Haldenbachstrasse 18, 8091, Zurich, Switzerland

    Annina Seiler, Richard Klaghofer, Natalie Drabe, Vera Hinderling-Baertschi, Annette Boehler & Josef Jenewein

  2. Department of Psychology, University of Fribourg, Fribourg, Switzerland

    Chantal Martin-Soelch

  3. Department of Psychosomatic Medicine and Psychotherapy, Segeberger Kliniken, Bad Segeberg, Germany

    Lutz Goetzmann

  4. Clinic for Psychotherapy and Psychosomatics Hohenegg, Meilen, Switzerland

    Stefan Buechi

Authors
  1. Annina Seiler
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  2. Richard Klaghofer
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  3. Natalie Drabe
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  4. Chantal Martin-Soelch
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  5. Vera Hinderling-Baertschi
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  6. Lutz Goetzmann
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  7. Annette Boehler
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  9. Josef Jenewein
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Corresponding author

Correspondence to Annina Seiler.

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Seiler, A., Klaghofer, R., Drabe, N. et al. Patients’ Early Post-Operative Experiences with Lung Transplantation: A Longitudinal Qualitative Study. Patient 9, 547–557 (2016). https://doi.org/10.1007/s40271-016-0174-z

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  • DOI: https://doi.org/10.1007/s40271-016-0174-z

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