Learning to Live Again: The Role of Education in Heart Transplant Recipients

Heart Transplantation-Postoperative Considerations

Heart transplantation (HT) remains the best treatment of patients with severe heart failure who are deemed to be transplant candidates. The authors discuss postoperative management of the HT recipient by system, emphasizing areas where care might differ from other cardiac surgery patients. Working together, critical care physicians, heart transplant surgeons and cardiologists, advanced practice providers, pharmacists, transplant coordinators, nursing staff, physical therapists, occupational therapists, rehabilitation specialists, nutritionists, health psychologists, social workers, and the patient and their loved ones partner to increase the likelihood of a successful outcome.

An educational design and development project for pediatric heart transplant recipients and their families

PURPOSE

The purpose of this project is to systematically derive and develop educational content for children who have undergone heart transplants and their families to improve the families' and caregivers' ability to manage child health in South Korea.

DESIGN AND METHODS

This project developed educational content through the first three steps: "Analysis," "Design," and "Development" of the five steps outlined in the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. The educational contents were derived from an analysis of six literature reviews and six studies, seven websites, and interviews with six caregivers of children who have undergone a heart transplant. Based on these analyses, educational items were designed. When a draft of the education contents was developed, the content validity was validated by ten experts.

RESULTS

Educational items were designed in nine major categories and 40 sub-categories. All contents were validated with a content validity index of at least 0.8 or higher and included in the education content for pediatric heart transplant families, with recommendations for further modification based on expert advice.

PRACTICE IMPLICATIONS

This project is meaningful in that it has developed health management education contents suitable for the situation in South Korea through analyzing previous studies and educational contents of domestic and international medical centers as well as an in-depth interview with caregivers.

Clinical outcomes of a nurse-led post-discharge education program for heart-transplant recipients: A retrospective cohort study

BACKGROUND

Advances in immunosuppressive therapeutics and medical technology have improved survival rates after heart transplantation. Although there is a rigorous schedule of outpatient visits and testing to detect early signs of rejection and other complications in the first year after transplantation, repeated unplanned readmissions of heart transplant recipients remains a challenge.

OBJECTIVE

This study aimed to compare the effects of specialized nurse-led discharge education, including continuous post-transplant education and counselling, on heart transplant recipients' clinical outcomes, with the effects of existing discharge education.

METHODS

Participants were 136 heart transplantation recipients at a university-affiliated hospital in South Korea from November 1, 1994, to November 30, 2018. Participants' electronic medical records were retrospectively analyzed. Participants were grouped according to usual care (n = 25), nurse-led program (n = 66), and nurse-led program with post-discharge education (n = 45). We assessed the number of outpatient visits with clinical problems and days to first unplanned rehospitalization within one year after transplantation.

RESULTS

The nurse-led program with post-discharge education was associated with significantly reduced outpatient visits with clinical problems, compared to usual care and the existing nurse-led program. We also found a significantly longer time until first unplanned rehospitalization in the nurse-led program with post-discharge education group, compared to the usual care group.

CONCLUSION

This study identified the heart transplantation-specialized nurse-led discharge and subsequent post-discharge education as an effective strategy for positive clinical outcomes within one year after heart transplantation.