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Wang R, Peng F, Guo S, Sun J, Zhang S, Li X, Wei C, Liu H. Elements of Post-Transplant Recovery in Lung Transplant Recipients: A Scoping Review. Clin Nurs Res 2024; 33:481-492. [PMID: 38770918 DOI: 10.1177/10547738241253644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
To clarify and refine the specific elements of post-transplant recovery in lung transplant recipients, we explored the four dimensions of recovery: physiological, psychological, social, and habitual. This study is a scoping review. Two authors conducted a comprehensive electronic literature search to identify studies published from the establishment of the database to August 2022. Deductive coding was utilized to identify and categorize elements using a predefined list of the four components (physiological, psychological, social, and habitual recovery) based on the framework of post-transplant recovery proposed by Lundmark et al. Inductive coding was applied for concepts requiring further classification. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Systematic searching identified 8,616 potential records, of which 51 studies met the inclusion criteria. Ten subdimensions and their corresponding elements were identified and categorized into four dimensions of recovery following lung transplantation. The subdimensions included physiological recovery (including symptom experience, complications, physical function, and energy reserve), psychological recovery (encompassing affective distress, psychological adaptation, and transition from illness to health), social recovery (involving family adaptation and social adaptation), and habit recovery (focusing on health behavior).
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Affiliation(s)
- Ruiting Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Fucong Peng
- Beijing University of Chinese Medicine, Beijing, China
| | - Shaobo Guo
- Beijing University of Chinese Medicine, Beijing, China
| | - Jing Sun
- China-Japan Friendship Hospital, Beijing, China
| | - Shuping Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiangru Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Changyun Wei
- Beijing University of Chinese Medicine, Beijing, China
| | - Hongxia Liu
- Beijing University of Chinese Medicine, Beijing, China
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Visintini C, Mansutti I, Palese A. What Are the Perceptions of Recipients of Allogeneic Hematopoietic Stem Cell Transplant About Medication Adherence?: A Synthesis of Qualitative Studies. Cancer Nurs 2024:00002820-990000000-00228. [PMID: 38498800 DOI: 10.1097/ncc.0000000000001344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Recipients of allogeneic hematopoietic stem cell transplant (HSCT) may encounter difficulties in adhering to their post-transplant medication as prescribed to avoid complications. Despite the relevance of patients' perspectives to inform the clinical practice, to date, no summary regarding their lived experience of oral medication adherence (MA) has been produced. OBJECTIVE To summarize the lived experience of MA by recipients of allogeneic HSCT as documented in qualitative studies. METHODS A systematic review and meta-synthesis of qualitative research was performed. Six databases were searched up to June 27, 2023. Four qualitative studies met eligibility and were included: those designed and conducted with scientifically sound methodologies and those regarding adult patients who had undergone allogeneic HSCT and required an oral medication regimen in the post-transplant phase. Data were extracted and synthesized using thematic analysis. RESULTS Four analytical themes were identified: "The initiation is a challenge," "Time as a new issue," "Internal and external obstacles threaten medication adherence," and "Different strategies are the answer to medication non-adherence." CONCLUSIONS Medication adherence in patients after HSCT is a complex phenomenon wherein different factors play a role. When designing targeted interventions to improve MA, it is imperative to start with patients' experiences and perspectives. IMPLICATIONS FOR PRACTICE Patients developed different strategies to deal with obstacles to MA that may inform daily practice. Before discharge, healthcare professionals should emphasize to both patients and carers the importance of MA.
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Affiliation(s)
- Chiara Visintini
- Author Affiliations: Department of Biomedicine and Prevention, University of Rome Tor Vergata (Ms Visintini); and School of Nursing, Department of Medical Sciences, University of Udine (Drs Mansutti and Palese), Italy
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Laskowski NM, Brandt G, Tigges-Limmer K, Halbeisen G, Paslakis G. Donor and Donation Images (DDI)-A Scoping Review of What We Know and What We Don't. J Clin Med 2023; 12:jcm12030952. [PMID: 36769600 PMCID: PMC9917729 DOI: 10.3390/jcm12030952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
Organ transplantation is associated with significant physical and psychological burden for the recipients. Qualitative reports indicate that organ recipients develop donor and donation images (DDI)-conceptions of the donor and/or the organ. A deeper understanding of DDI is needed in the care of transplant recipients. To present the current state of knowledge, we searched for and identified DDI-related publications in PubMed and Scopus. Inclusion criteria were (1) studies addressing transplant recipients, and (2) English or German language. Twenty-one studies of individuals with transplanted hearts, lungs, or kidneys were included in this scoping review. Prevalence for DDI ranged from 6% to 52.3%. DDI occurs both before and after transplantation and includes ideas about the donor as well as whether and how the recipient's personality may be altered by the transplanted organ. Some transplant recipients did indeed report personality changes following transplantation due to the adoption of assumed donor characteristics. One study showed a positive association between the presence of DDI and anxiety scores and one described a coping effect. DDI is understudied and should be systematically assessed to improve care for the vulnerable group of individuals undergoing organ transplantation. Current research gaps and future directions are discussed.
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Affiliation(s)
- Nora M. Laskowski
- University Clinic for Psychosomatic Medicine and Psychotherapy, Campus East-Westphalia, Medical Faculty, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany
| | - Gerrit Brandt
- University Clinic for Psychosomatic Medicine and Psychotherapy, Campus East-Westphalia, Medical Faculty, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany
| | - Katharina Tigges-Limmer
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Campus East-Westphalia, Medical Faculty, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Campus East-Westphalia, Medical Faculty, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany
- Correspondence:
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A New Normality Illuminated by Past and Present! A Qualitative Study: Experiences and Challenges of Everyday Life in Patients With Advanced Heart or Lung Failure. Glob Qual Nurs Res 2022; 9:23333936221140374. [PMCID: PMC9716626 DOI: 10.1177/23333936221140374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022] Open
Abstract
The aim of this study was to gain insight into the phenomena of everyday life as experienced and coped with by patients living with advanced heart or lung failure. We employed a qualitative design using a phenomenological hermeneutic approach. Data derived from 10 nursing consultations in a holistic setting. Ricoeur’s theory of interpretation inspired the text analysis. The study emphasizes time (past, present, and future) as an overall everyday life theme, playing an essential role associated with improvements or poor outcomes related to physical, mental, and intersubjective challenges. Patients accepted and lived with the challenges, experiencing changes, as transition, but also coped with their new normal, which involved improvements or poor outcomes, some invisible to the community. Assumptions about everyday life changed significantly, the changes possibly essential for intersubjective relations. A reflective approach, can help patients to evolve, using knowledge from the past and present to cope with the future.
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Jobst S, Schaefer J, Kleiser C, Kugler C. A Systematized Review of Professional Employment Following Thoracic Transplantation. Prog Transplant 2022; 32:55-66. [PMID: 35006009 DOI: 10.1177/15269248211064883] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Acknowledging the evolved landscape in thoracic transplantation, professional employment becomes an important outcome measure to quantify the success of this costly procedure. OBJECTIVE We aimed to assess rates of and characterize factors associated with professional employment in patients following thoracic transplantation, and create an evidence-base on the relationship between professional employment and relevant outcome parameters. METHODS We systematically searched Medline, Cinahl, and GoogleScholar to identify studies published between 1998 and 2021 reporting on professional employment following heart and lung transplantation. RESULTS Twenty-two studies from 11 countries with varying sample sizes (N = 27; 10 066) were included. Employment rates ranged from 19.7% to 69.4% for heart, and from 7.4% to 50.8% for lung transplant recipients. Most frequently reported positively associated factors with employment after transplant were younger age, higher education, and history of pretransplant employment. Longer duration of unemployment prior to transplantation and Medicaid coverage were the most frequently reported negatively associated factors. Relationships between professional employment and clinical outcomes included lower rates of acute and chronic rejection, less infection episodes, and better quality of life among working patients; one study reported a lower 5-year-mortality rate. Reasons not to work were "physical or mental health-related," "employment-related," "financial reasons," and "lifestyle choices." DISCUSSION Substantial proportions of patients following thoracic transplantation are not professionally employed, potentially diminishing the success of transplantation on individual and societal levels. Considering adverse clinical outcomes in employed transplant recipients were low, more efforts are needed to identify modifiable factors for employment in these populations.
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Affiliation(s)
- Stefan Jobst
- Institute of Nursing Science, University of Freiburg, Freiburg, Germany
| | - Jonas Schaefer
- Institute of Nursing Science, University of Freiburg, Freiburg, Germany
| | - Christina Kleiser
- Institute of Nursing Science, University of Freiburg, Freiburg, Germany
| | - Christiane Kugler
- Institute of Nursing Science, University of Freiburg, Freiburg, Germany
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Glaze JA, Brooten D, Youngblut JA, Hannan J, Page T. The Lived Experiences of Caregivers of Lung Transplant Recipients. Prog Transplant 2021; 31:299-304. [PMID: 34704858 DOI: 10.1177/15269248211046034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Lung transplantation is a treatment crucial for the survival of patients with end-stage lung diseases. An identified caregiver is obligatory for a patient to be eligible for a lung transplant and plays an essential role in the transplant recipient's care. Most caregiver research, however, has been on caregivers of persons with Alzheimer's disease or the elderly, with limited research on caregivers' experiences caring for transplant recipients. This study examined the experiences of caregivers of recipient's pre- and post-lung transplantation. METHODS/APPROACH Caregivers of lung transplant recipients were recruited using purposeful sampling. Audiotaped semi-structured open ended interviews were conducted until data saturation. Each interview was transcribed verbatim, and conventional content analysis performed to extract significant themes and subthemes. FINDINGS Four main themes and 12 sub-themes were identified. The former included (1) establishing the diagnosis, (2) caregiver roles, (3) caregiver psychological and psychosocial issues, and (4) support. Caregivers lacked basic knowledge related to lung transplantation. The caregivers' roles necessitated rearranging priorities, lifestyle changes, and redirecting emotional and physical energy. Support played an important role in caregiving experiences. DISCUSSION Each caregiver shared their unique caregiving experiences. Caregivers lack knowledge about transplantation, experience dramatic changes in their family life, social activities, employment, and often financial status. Healthcare providers can use the findings of this study in developing informational, and psychological interventions to alleviate caregivers' stress and anxiety.
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Affiliation(s)
- Joy A Glaze
- Miami Transplant Institute, 23215Jackson Memorial Hospital/University of Miami School, Miami, Florida, USA
| | - Dorothy Brooten
- 15803Florida International University, Nichole Wertheim College of Nursing & Health Sciences, Miami, Florida, USA
| | - Jo Anne Youngblut
- 15803Florida International University, Nichole Wertheim College of Nursing & Health Sciences, Miami, Florida, USA
| | - Jean Hannan
- 15803Florida International University, Nichole Wertheim College of Nursing & Health Sciences, Miami, Florida, USA
| | - Timothy Page
- 2814Nova Southeastern University, Fort Lauderdale, Florida, USA
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Tang J, Kerklaan J, Wong G, Howell M, Scholes-Robertson N, Guha C, Kelly A, Tong A. Perspectives of solid organ transplant recipients on medicine-taking: Systematic review of qualitative studies. Am J Transplant 2021; 21:3369-3387. [PMID: 33866675 DOI: 10.1111/ajt.16613] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/16/2021] [Accepted: 04/02/2021] [Indexed: 01/25/2023]
Abstract
Medicine-taking among transplant recipients is a complex and ubiquitous task with significant impacts on outcomes. This study aimed to describe the perspectives and experiences of medicine-taking in adult solid organ transplant recipients. Electronic databases were searched to July 2020, and thematic synthesis was used to analyze the data. From 119 studies (n = 2901), we identified six themes: threats to identity and ambitions (impaired self-image, restricting goals and roles, loss of financial independence); navigating through uncertainty and distrust (lacking tangible/perceptible benefits, unprepared for side effects, isolation in decision-making); alleviating treatment burdens (establishing and mastering routines, counteracting side effects, preparing for the unexpected); gaining and seeking confidence (clarity with knowledge, reassurance through collective experiences, focusing on the future outlook); recalibrating to a new normal posttransplant (adjusting to ongoing dependence on medications, in both states of illness and health, unfulfilled expectations); and preserving graft survival (maintaining the ability to participate in life, avoiding rejection, enacting a social responsibility of giving back). Transplant recipients take medications to preserve graft function, but dependence on medications jeopardizes their sense of normality. Interventions supporting the adaptation to medicine-taking and addressing treatment burdens may improve patient satisfaction and capacities to take medications for improved outcomes.
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Affiliation(s)
- James Tang
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jasmijn Kerklaan
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Department of Pediatric Nephrology, Academic Medical Center, Emma Children's Hospital, Amsterdam, the Netherlands
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Ayano Kelly
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Life experiences of adult heart transplant recipients: a new life, challenges, and coping. Qual Life Res 2021; 30:1619-1627. [PMID: 33523403 DOI: 10.1007/s11136-021-02763-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The process during and after heart transplantation is quite complicated, and studies addressing patient experiences are needed. Heart transplantation particularly affects the recipients' activities of daily living and exposes them to various complications. The aim of this study is to explore the experiences of heart transplant recipients during and after heart transplantation. METHODS This qualitative, phenomenological research was conducted with 11 heart transplant recipients in the university hospital, which is one of the 14 heart transplantation centers in Turkey. The data were collected through in-depth semi-structured interviews in a private room that ensured both the comfort of the participants and the necessary conditions for safe data collection. The interviews were recorded using an audio recorder, transcribed, and then analyzed using inductive content analysis. Data collection was terminated after the 11th interview when the data reached the saturation point. RESULTS The study data were categorized into the following three main themes and subthemes: (1) a new life with a new heart; an opportunity arising at an unexpected time, heart donation, and transplantation as a value, (2) challenges; management of medication therapy and side effects, emotion management, maintaining social relations, and social stigma, and (3) coping; faith in God and praying, responsibility of living with a blessing (donated heart), health professional support, family support, and peer counseling. In line with these themes, expressions of value given to new life and gratitude to heart transplantation were important. The availability and diversity of support sources came to the fore in coping. Social stigma expressions of especially male patients were remarkable in challenges. CONCLUSION At the end of the study, the experiences of heart transplant recipients were obtained regarding a new life with a new heart, challenges, and coping. The study results provide an insight into the challenges that the heart transplant recipients face and their coping strategies, guiding the healthcare professionals. The challenges and relevant coping strategies of heart transplant recipients may be integrated into clinical practice and may help plan patient's care. The results may also be used to design and implement an intervention program to improve care for these patients.
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9
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The experiences of adult heart, lung, and heart-lung transplantation recipients: A systematic review of qualitative research evidence. PLoS One 2020; 15:e0241570. [PMID: 33175900 PMCID: PMC7657484 DOI: 10.1371/journal.pone.0241570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 10/18/2020] [Indexed: 11/19/2022] Open
Abstract
Aim To review evidence about the experience of being the recipient of a donated heart, lungs, or heart and lungs. Design A systematic review (registered with PROSPERO: CRD42017067218), in accordance with PRISMA guidelines. Data sources Seven databases and Google Scholar were searched in May 2017 and July 2019 for papers reporting English-language research that had used qualitative methods to investigate experiences of adult recipients. Review methods Quality was assessed and results were analysed thematically. Results 24 papers (reporting 20 studies) were eligible and included. Their results were organised into three chronological periods: pre-transplant (encompassing the themes of ‘dynamic psychosocial impact’, ‘resources and support’), transplant (‘The Call’, ‘intensive care unit’), and post-transplant (‘dynamic psychosocial impact’, ‘management’, ‘rejection’). Sub-themes were also identified. It was evident that contemplating and accepting listing for transplantation entailed or amplified realisation of the precipitating illness’s existential threat. The period surrounding transplantation surgery was marked by profound, often surreal, experiences. Thereafter, although life usually improved, it incorporated unforeseen challenges. The transplantation clinic remained important to the recipient. The meaning of the clinic and its staff could be both reassuring (providing care and support) and threatening (representing onerous medical requirements and potential organ rejection). Conclusion This review has implications for the psychosocial care of transplant recipients and indicates the need for further research to gain insight into the experience of receiving a donated heart and/or lung. Impact Medical consequences of heart and lung transplantation are well documented; this is the first systematic review of research using qualitative methods to investigate the experience of heart, lung, and heart-and-lung transplantation. The psychosocial impact of transplantation was found to be dynamic and complex, with notable features evident before, during, and after transplantation. Clinic staff remained significant to recipients. It is clear that recipients need continuing psychosocial as well as medical support.
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Ribaut J, Leppla L, Teynor A, Valenta S, Dobbels F, Zullig LL, De Geest S. Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: the SMILe implementation science project. BMC Health Serv Res 2020; 20:827. [PMID: 32878623 PMCID: PMC7465386 DOI: 10.1186/s12913-020-05636-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/09/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Medication adherence to immunosuppressants in allogeneic stem cell transplantation (alloSCT) is essential to achieve favorable clinical outcomes (e.g. control of Graft-versus-Host Disease). Over 600 apps supporting medication adherence exist, yet they lack successful implementation and sustainable use likely because of lack of end-user involvement and theoretical underpinnings in their development and insufficient attention to implementation methods to support their use in real-life settings. Medication adherence has three phases: initiation, implementation and persistence. We report the theory-driven development of an intervention module to support medication adherence (implementation and persistence phase) in alloSCT outpatients as a first step for future digitization and implementation in clinical setting within the SMILe project (Development, implementation and testing of an integrated care model in allogeneic SteM cell transplantatIon faciLitated by eHealth). METHODS We applied Michie's Behavior Change Wheel (BCW) and the Capability-Opportunity-Motivation and Behavior (COM-B) model using three suggested stages followed by one stage added by our team regarding preparation for digitization of the intervention: (I) Defining the problem in behavioral terms; (II) Identifying intervention options; (III) Identifying content and implementation options; (IV) SMILe Care Model Prototype Development. Scientific evidence, data from a contextual analysis and patients'/caregivers' and clinical experts' inputs were compiled to work through these steps. RESULTS (I) Correct immunosuppressant taking and timing were defined as target behaviors. The intervention's focus was determined within the COM-B dimensions Capability (lack of knowledge, lack of routine), Opportunity (lack of cues, interruptions in daily routine) and Motivation (lack of problem solving, trivialization). (II) Five intervention functions were chosen, i.e. education, training, modelling, persuasion and enablement. (III) Twenty-four behavior change techniques were selected, e.g., goal setting, action planning and problem solving. (IV) Finally, seventeen user stories were developed to guide the SMILeApp's software development process. CONCLUSION Our example on the theory-driven development of an intervention module in alloSCT delivered by eHealth and transplant team using a rigorous 3 + 1-stage approach based on BCW, COM-B and agile software development techniques, can be used as methodological guidance for other eHealth intervention developers. Our approach has the potential to enhance successful implementation and sustained use of eHealth solutions in real-life settings.
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Affiliation(s)
- Janette Ribaut
- Department Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.,Department of Hematology, University Hospital of Basel, 4031, Basel, Switzerland
| | - Lynn Leppla
- Department Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.,Departments of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, 79110, Freiburg im Breisgau, Germany
| | - Alexandra Teynor
- Department of Computer Science, University of Applied Sciences, Augsburg, Germany
| | - Sabine Valenta
- Department Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.,Department of Hematology, University Hospital of Basel, 4031, Basel, Switzerland
| | - Fabienne Dobbels
- Department Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.,Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, 3000, Leuven, Belgium
| | - Leah L Zullig
- Department of Population Health Science, Duke University, Durham, NC, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Sabina De Geest
- Department Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. .,Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, 3000, Leuven, Belgium.
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11
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Graarup J, Højskov IE. Patients' perspective of attending nursing consultations-A pilot and feasibility study. Nurs Open 2020; 7:1482-1488. [PMID: 32802368 PMCID: PMC7424430 DOI: 10.1002/nop2.522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/18/2020] [Accepted: 05/04/2020] [Indexed: 11/07/2022] Open
Abstract
Aim The aims were to explore: (a) how patients with advanced heart and lung failure accept the overall framework of the nursing consultations and (b) the patients' acceptability and applicability of the nursing consultations. Design Qualitative study. Methods Interviews were conducted in an holistic frame and analysed using Graneheim and Lundman's qualitative content thematic analysis. Patients were interviewed between April and May 2018 regarding their general view of the nursing consultation and their experience of the framework inspired by R. R. Parse. Results The overall theme was A confidential moment with the nurse to deal with and become more aware of what is important, based on following subthemes: "An option that makes sense," "Scheduled time with the nurse is important" and "To find a new normality in everyday life." The framework addressed a space of freedom requested by the informants, for whom attending nursing consultations was useful and meaningful, enabling them to reflect on everyday challenges.
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Affiliation(s)
- Jytte Graarup
- Department of Cardiothoracic SurgeryThe Centre for Cardiac, Vascular‐ Pulmonary and Infectious DiseasesRigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Ida Elisabeth Højskov
- Department of Cardiothoracic SurgeryThe Centre for Cardiac, Vascular‐ Pulmonary and Infectious DiseasesRigshospitaletUniversity of CopenhagenCopenhagenDenmark
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Effect of Preoperative Video Information on Anxiety and Satisfaction in Patients Undergoing Abdominal Surgery. ACTA ACUST UNITED AC 2019; 37:430-436. [DOI: 10.1097/cin.0000000000000505] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kim J, Kim K, Jang I. Symptom Experience, Self-Care Adherence, and Quality of Life Among Heart Transplant Recipients in South Korea. Clin Nurs Res 2017; 28:182-201. [DOI: 10.1177/1054773817740531] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Among heart transplant recipients, the perceived quality of life (QOL) is a key indicator of successful transplantation. QOL is affected by posttransplant treatments, including immunosuppressive therapy or self-care. However, few studies have evaluated QOL after heart transplantation in South Korea. This study aimed to investigate posttransplant symptoms associated with immunosuppressant, self-care adherence, and QOL in 105 heart transplant recipients in South Korea. Educational status (β = −1.05, p = .013), symptoms (β = −3.98, p = .004), and diet (β = 0.38, p < .001) were found to affect subjects’ overall QOL. In addition to these factors, caregivers and the duration of heart disease (years) were found to be influencing factors, depending on the individual QOL subdimension. These findings highlight the importance of controlling symptoms and managing medications as well as of self-care (particularly dietary compliance). Educational programs targeting beneficial changes in lifestyle, including diet, are needed.
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Affiliation(s)
- Jisu Kim
- Chung-Ang University, Seoul, South Korea
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Ivarsson B, Ingemansson R, Sjöberg T. Experiences of supportive care when waiting for a lung re-transplantation. SAGE Open Med 2017; 5:2050312117697151. [PMID: 28540044 PMCID: PMC5433791 DOI: 10.1177/2050312117697151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/23/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives: Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients’ and next of kin’s experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs. Methods: Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation. Results: The experiences of supportive care were captured in one main category: ‘once again haunted by death’ and three sub-categories: ‘when life turns and death once again snorts down your neck’, ‘the importance of information’, and ‘perceptions of support’. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown. Conclusion: This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.
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Affiliation(s)
- Bodil Ivarsson
- Department of Clinical Sciences, Lund, Lund University, Lund, Sweden.,Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
| | - Richard Ingemansson
- Department of Clinical Sciences, Lund, Lund University, Lund, Sweden.,Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
| | - Trygve Sjöberg
- Department of Clinical Sciences, Lund, Lund University, Lund, Sweden.,Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
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15
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Graarup J, Mogensen EL, Missel M, Berg SK. Life after a lung transplant: a balance of joy and challenges. J Clin Nurs 2017; 26:3543-3552. [PMID: 28071839 DOI: 10.1111/jocn.13724] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVE To describe patients' experiences throughout the first four months post-lung transplant. BACKGROUND Health professionals are familiar with the fact that patients' average survival after a lung transplant is about seven years and that 74% of these patients reject new organs within the first two years. By contrast, knowledge of these patients' perspectives after lung transplantation is scant. DESIGN/METHOD A qualitative study was conducted between May 2013-May 2014 in which 26 interviewees participated - four months post-transplant - based on a semistructured interview guide. The data were inductively analysed using a content thematic approach within a phenomenological and hermeneutic frame. RESULTS The main findings in the study reveal that (1) having a lung transplant is an overwhelming experience, which for some patients includes (2) troubling physical and psychological challenges. The interviewees were happy to get another chance to live, although some of them suffered from medical side effects, postoperative complications and psychological problems. When asked about the future, interviewees stated that life could be described as (3) a balance of joy and challenges. They had received a new chance in life and were eager to fulfil their life hopes and dreams. At the same time, they were worried about the future. Having a lung transplant implies rules that have to be followed. What are the healthy choices they are supposed to make? And will there be a tomorrow? CONCLUSIONS Having a lung transplant is described as an overwhelming experience because of the improvement in the physical function of the body. Patients were grateful to family, friends and healthcare professionals for supporting them. The first four months post-transplantation were described as both physically and psychologically challenging. Interviewees were aware of the prognosis for patients following lung transplantation. They expressed feelings of worry and insecurity but still had hopes and dreams. RELEVANCE TO CLINICAL PRACTICE The patients are troubled by both physical and psychological challenges after lung transplantation. Several areas call for interventions from healthcare professionals during the early post-transplant period.
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Affiliation(s)
- Jytte Graarup
- Copenhagen University Hospital, Rigshospitalet, the Heart Center, Copenhagen, Denmark
| | | | - Malene Missel
- Copenhagen University Hospital, Rigshospitalet, the Heart Center, Copenhagen, Denmark
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16
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Ågren S, Sjöberg T, Ekmehag B, Wiborg MB, Ivarsson B. Psychosocial aspects before and up to 2 years after heart or lung transplantation: Experience of patients and their next of kin. Clin Transplant 2017; 31. [PMID: 28039882 DOI: 10.1111/ctr.12905] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Psychosocial factors are important for patients undergoing heart (HTx) or lung (LTx) transplantation and for their next of kin (NoK). AIM To describe health-related quality of life (HRQoL; patients only), anxiety, depression, stress, coping ability, and burden (NoK only) for patients and their NoK before and up to 2 years after HTx or LTx. DESIGN Adult patients (28 hearts and 26 lungs) and their appointed NoK were surveyed with questionnaires about specific psychosocial topics when they were accepted for the transplantation waiting list and 6 months, 1 year, and 2 years after transplantation. FINDINGS Patients' coping ability and self-perceived health were low at baseline and improved over time after transplantation. However, lung patients took longer time to recover in terms of HRQoL, depression, and stress than heart patients. Similarly, NoK of lung patients experienced a higher burden and more stress 1 year after transplantation than NoK of heart patients. CONCLUSIONS Healthcare professionals should be aware of the psychosocial challenges patients and their NoK face in daily living and provide support both before and after heart or lung transplantation.
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Affiliation(s)
- Susanna Ågren
- Department of Cardiothoracic Surgery, Lund University, Lund, Sweden.,Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardiothoracic Surgery, Linköping University, Linköping, Sweden
| | - Trygve Sjöberg
- Department of Cardiothoracic Surgery, Lund University, Lund, Sweden.,Department of Cardiothoracic Surgery, Skåne University Hospital Lund, Lund, Sweden
| | - Björn Ekmehag
- Department of Public Health and Caring Science, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Maj-Britt Wiborg
- Department of Cardiology, Skåne University Hospital Lund, Lund, Sweden
| | - Bodil Ivarsson
- Department of Cardiothoracic Surgery, Lund University, Lund, Sweden.,Department of Cardiothoracic Surgery, Skåne University Hospital Lund, Lund, Sweden
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17
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Almgren M, Lennerling A, Lundmark M, Forsberg A. The meaning of being in uncertainty after heart transplantation - an unrevealed source to distress. Eur J Cardiovasc Nurs 2016; 16:167-174. [PMID: 27146379 DOI: 10.1177/1474515116648240] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND As many as 88% of heart transplant recipients (HTRs) suffer from psychological distress. Both psychosocial factors and physical health are associated with increased psychological distress. However, the causes and impacts of psychological distress are unclear. HTRs strive for a sense of control over their health and daily lives in order to improve their psychological well-being. Perceived control was found to be related to the patients' construction of normality, their emotional state, as well as their thoughts and feelings of uncertainty about the future. AIM An in-depth exploration of the meaning of uncertainty during the first year after a heart transplantation (HTX). METHOD A phenomenological-hermeneutic method was employed. Interviews were conducted with 14 patients, four women and ten men, with a mean age of 51 years (range: 28-67 years). RESULTS Being in uncertainty after HTX means losing a sense of coherence, which shatters the HTR's whole worldview. The HTRs search for meaning and strive for coherence, which is no longer achievable. By using a nursing theory, we understand that uncertainty should be seen as a natural state among HTRs. It constitutes the starting point from which the HTRs can reorganise their self-structure and find a new view of life. When striving for normality, certainty and predictability (i.e., the healthcare professional's perspective), we block or prolong this process, thus causing distress among HTRs because they are unable to create a new orientation in life. CONCLUSION This study presents a hypothesis of the primary cause of psychological distress after HTX and provides a useful framework for how to approach this condition.
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Affiliation(s)
- Matilda Almgren
- 1 Skåne University Hospital, Thoracic Intensive Care Unit, Lund, Sweden.,2 Department of Health Sciences at Lund University, Lund, Sweden
| | - Annette Lennerling
- 3 The Transplant Centre Sahlgrenska University Hospital, Gothenburg, Sweden.,4 The Institute of Health and Caring Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Martina Lundmark
- 1 Skåne University Hospital, Thoracic Intensive Care Unit, Lund, Sweden.,2 Department of Health Sciences at Lund University, Lund, Sweden
| | - Anna Forsberg
- 2 Department of Health Sciences at Lund University, Lund, Sweden.,5 Skåne University Hospital, Department of Transplantation and Cardiology, Lund, Sweden
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18
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Patients’ Early Post-Operative Experiences with Lung Transplantation: A Longitudinal Qualitative Study. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2016; 9:547-557. [DOI: 10.1007/s40271-016-0174-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Vasconcelos AGD, Pessoa VLMDP, Menezes FWP, Florêncio RS, Frota MXF. Repercussões no cotidiano dos pacientes pós-transplante cardíaco. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Conhecer as repercussões no cotidiano de pacientes submetidos a transplante cardíaco. Métodos Trata-se de estudo descritivo, qualitativo, conduzido em um centro de transplantes do nordeste brasileiro. Nove pacientes submetidos ao transplante cardíaco participaram do estudo, tendo sido utilizada para coleta dos dados a técnica de grupo focal, facilitada em quatro reuniões. Os recortes de suas falas resultaram em duas categorias temáticas: ser transplantado cardíaco - o antes e o depois; e sentimentos e percepções sobre o transplante cardíaco. Resultados A pessoa submetida ao transplante identificou as modificações positivas obtidas após o procedimento, porém ressentiu-se com as inúmeras proibições, com interferência direta em seu cotidiano; as limitações decorrentes do transplante ganharam destaque e não permitiram que os pacientes se sentissem realmente curados. Conclusão Os participantes reconheceram o transplante cardíaco como uma solução para seus sintomas clínicos, contudo, com significativa perda de autonomia, obrigando-os a um intenso esforço adaptativo.
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20
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The Unsteady Mainstay of the Family: Now Adult Children's Retrospective View on Social Support in Relation to Their Parent's Heart Transplantation. Nurs Res Pract 2014; 2014:541241. [PMID: 25431662 PMCID: PMC4241330 DOI: 10.1155/2014/541241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/06/2014] [Accepted: 10/14/2014] [Indexed: 11/26/2022] Open
Abstract
The needs for support among children with a seriously ill parent, who is waiting for heart transplantation, are unknown today. The aim was to describe now adult children's experiences of social support in relation to a parent's heart transplant during childhood. Nine females and four males were interviewed. The median age for the children was 18 at the transplantation and their parents had been ill before for 18 months (median) and on waiting list for 161 days (mean). Three categories emerged: health care professionals' approaches, family and friends' approaches, and society approaches. Our results show that there was lack of support for children of heart transplantation patients. Support in the shape of information was in most cases provided by the sick or healthy parent. It is of great clinical importance to develop psychosocial support programs for children with a seriously ill parent waiting for heart transplantation (before, during, and after surgery).
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21
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Ivarsson B, Ekmehag B, Sjöberg T. Relative's experiences before and after a heart or lung transplantation. Heart Lung 2014; 43:198-203. [DOI: 10.1016/j.hrtlng.2014.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 02/16/2014] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
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22
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Suhling H, Rademacher J, Zinowsky I, Fuge J, Greer M, Warnecke G, Smits JM, Bertram A, Haverich A, Welte T, Gottlieb J. Conventional vs. tablet computer-based patient education following lung transplantation--a randomized controlled trial. PLoS One 2014; 9:e90828. [PMID: 24608864 PMCID: PMC3946627 DOI: 10.1371/journal.pone.0090828] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/21/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Accurate immunosuppression is of critical importance in preventing rejection, while avoiding toxicity following lung transplantation. The mainstay immunosuppressants are calcineurin inhibitors, which require regular monitoring due to interactions with other medications and diet. Adherence to immunosuppression and patient knowledge is vital and can be improved through patient education. Education using tablet-computers was investigated. OBJECTIVE To compare tablet-PC education and conventional education in improving immunosuppression trough levels in target range 6 months after a single education. Secondary parameters were ratio of immunosuppression level measurements divided by per protocol recommended measurements, time and patient satisfaction regarding education. DESIGN Single-centre, open labelled randomised controlled trial. PARTICIPANTS Patients >6 months after lung-transplantation with <50% of calcineurin inhibitor trough levels in target range. INTERVENTION Tablet-pc education versus personal, nurse-led education. MEASUREMENTS Calcineurin inhibitor levels in target range 6 months after education, level variability, interval adherence, knowledge and adherence was studied. As outcome parameter, renal function was measured and adverse events registered. RESULTS Sixty-four patients were 1:1 randomised for either intervention. Levels of immunosuppression 6 months after education were equal (tablet-PC 58% vs. conventional 48%, p = 0.27), both groups improved in achieving a CNI trough level within target range by either education method (delta tablet-PC 29% vs. conventional 20%). In all patients, level variability decreased (-20.4%), whereas interval adherence remained unchanged. Knowledge about immunosuppression improved by 7% and compliance tests demonstrated universal improvements with no significant difference between groups. CONCLUSION Education is a simple, effective tool in improving adherence to immunosuppression. Tablet-PC education was non-inferior to conventional education. TRIAL REGISTRATION ClinicalTrials.gov NCT01398488 http://clinicaltrials.gov/ct2/show/NCT01398488? term=gottlieb+tablet+pc+education&rank=1.
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Affiliation(s)
- Hendrik Suhling
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Jessica Rademacher
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Imke Zinowsky
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Jan Fuge
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Mark Greer
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Gregor Warnecke
- Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | | | - Anna Bertram
- Dept. of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Tobias Welte
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Jens Gottlieb
- Dept. of Respiratory Medicine, Hannover Medical School, Hannover, Germany
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