Elsevier

Heart & Lung

Volume 32, Issue 4, July–August 2003, Pages 250-257
Heart & Lung

Issues in cardiovascular nursing
Meaning and life purpose: the perspectives of post-transplant women

https://doi.org/10.1016/S0147-9563(03)00042-6Get rights and content

Abstract

Purpose

A descriptive, exploratory study was conducted to examine perceptions and meanings assigned to the experience of end-stage heart failure and transplant surgery in female recipients.

Methods

Data was collected from 33 female heart transplant recipients from a heart transplant clinic using quantitative and qualitative methods. Women completed the Life Attitudes Profile and Multiple Affect Adjective Checklist and participated in a semi-structured interview.

Results

Women on average had a meaning score of 30.64 ± 8.32 (range, 10-43) and a life purpose score of 40.12 ± 13.78 (range, 17-63). The participants reported high levels of anxiety, depression, and hostility. Women expressed feelings of fear and lack of control related to their heart disease and transplant; however, they also described optimism, faith, acceptance, altruism, self-transcendence, self-fulfillment, and changing life goals as strong motivators for recovery.

Conclusion

Women experience emotional distress as much as and beyond 5 years after heart transplantation. Their sense of meaning and life purpose is relatively high and is positively informed by several motivating factors that serve as coping resources throughout the recovery process.

Section snippets

Study subjects and data source

The setting for the study was a single, outpatient post-transplant clinic affiliated with a tertiary university-affiliated medical center. Following approval by the appropriate Institutional Review Board, 33 women who had participated in a parent study10 were asked to participate in this companion study. The inclusion criteria for study enrollment were the following: female gender; post-transplant status; oriented to time, place, and person; ability to read, write, and speak English; and

Quantitative data

The sample consisted of 33 women who had their heart transplant surgery an average of 4.6 ± 4.8 years (range 1-22 years) before study participation. The demographic and clinical characteristics of women are summarized in Table I.

Table II provides the total scores on the variables of interest for women. Women reported moderate degrees of meaning and life purpose. In addition, we found that women had moderate to high levels of anxiety, depression, and hostility. The correlational matrix for the

Discussion

Our findings support that women experience moderate levels of meaning and life purpose after heart transplant surgery. However, psychological distress (anxiety, depression, and hostility) was not uncommon in our sample. Similarly, earlier studies report on the high prevalence of psychological distress in the immediate recovery period1 and several years after heart transplantation.4, 15 Our findings validate previous data and support the presumption that heart transplantation is not a cure.

Conclusion

In summary, we found that despite the many challenges that women face both before and after heart transplant surgery, a majority of the participants were able to utilize coping strategies to help them regain control over their lives. Our findings support the need for clinicians to provide effective psychological counseling to women before and after transplant surgery that focuses on individual concerns and promotes positive meaning and optimistic coping behaviors. Facilitating dialogue about

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