Abstract：
BACKGROUND: Symptom distress after heart transplantation (HTx) is a significant problem causing uncertainty, low self-efficacy, and psychological distress. Few studies have addressed self-reported symptoms. The aim was to explore self-reported symptom distress from time on the waiting list to 5 years after HTx and its association with self-reported psychological well-being, chronic pain, and fatigue in order to identify possible predictors of psychological or transplant specific well-being.
METHODS: This multicenter, longitudinal cohort study includes 48 heart recipients (HTRs), 12 women, and 36 men, with a median age of 57 years followed from pretransplant to 5 years post-transplant. Symptom distress was explored by means of four instruments measuring psychological general wellbeing, transplant specific wellbeing, pain, and fatigue.
RESULTS: Transplant specific well-being for the whole improved in a stepwise manner during the first 5 years compared to pretransplant. Heart transplant recipients with poor psychological wellbeing were significantly more burdened by symptom distress, in particular sleep problems and fatigue, for up to 5 years after HTx, and their transplant-specific well-being never improved compared to baseline. The prevalence of pain varied from 40% to 60% and explained a significant proportion of the variance in transplant-specific well-being, while psychological general well-being was mainly predicted by overall symptom distress.
CONCLUSIONS: The presence of distressing symptoms explains a significant proportion of poor psychological wellbeing both among HTRs reporting chronic pain and those without pain.
METHODS: This multicenter, longitudinal cohort study includes 48 heart recipients (HTRs), 12 women, and 36 men, with a median age of 57 years followed from pretransplant to 5 years post-transplant. Symptom distress was explored by means of four instruments measuring psychological general wellbeing, transplant specific wellbeing, pain, and fatigue.
RESULTS: Transplant specific well-being for the whole improved in a stepwise manner during the first 5 years compared to pretransplant. Heart transplant recipients with poor psychological wellbeing were significantly more burdened by symptom distress, in particular sleep problems and fatigue, for up to 5 years after HTx, and their transplant-specific well-being never improved compared to baseline. The prevalence of pain varied from 40% to 60% and explained a significant proportion of the variance in transplant-specific well-being, while psychological general well-being was mainly predicted by overall symptom distress.
CONCLUSIONS: The presence of distressing symptoms explains a significant proportion of poor psychological wellbeing both among HTRs reporting chronic pain and those without pain.
摘要：
背景：心脏移植（HTx）后的症状困扰是导致不确定性的重要问题，低自我效能感,和心理困扰。很少有研究针对自我报告的症状。目的是探索从等待名单上的时间到HTx后5年的自我报告的症状困扰及其与自我报告的心理健康的关系，慢性疼痛,和疲劳，以确定心理或移植特定幸福感的可能预测因素。
方法：这个多中心，纵向队列研究包括48名心脏接受者(HTRs)，12个女人,36人,从移植前到移植后5年，平均年龄为57岁。通过四种测量心理总体幸福感的仪器来探索症状困扰，移植特定的健康，疼痛,和疲劳。
结果：与移植前相比，在最初的5年中，整体的移植特异性幸福感逐步改善。心理健康差的心脏移植受者因症状困扰而承受的负担明显更大，特别是睡眠问题和疲劳，HTX之后长达5年，与基线相比，他们的移植特异性健康状况从未改善。疼痛的患病率从40％到60％不等，并解释了移植特异性幸福感差异的显着比例，而心理总体幸福感主要由总体症状困扰预测。
结论：令人痛苦的症状的存在解释了在报告慢性疼痛的HTRs和没有疼痛的HTRs中心理健康差的显著比例。
方法：这个多中心，纵向队列研究包括48名心脏接受者(HTRs)，12个女人,36人,从移植前到移植后5年，平均年龄为57岁。通过四种测量心理总体幸福感的仪器来探索症状困扰，移植特定的健康，疼痛,和疲劳。
结果：与移植前相比，在最初的5年中，整体的移植特异性幸福感逐步改善。心理健康差的心脏移植受者因症状困扰而承受的负担明显更大，特别是睡眠问题和疲劳，HTX之后长达5年，与基线相比，他们的移植特异性健康状况从未改善。疼痛的患病率从40％到60％不等，并解释了移植特异性幸福感差异的显着比例，而心理总体幸福感主要由总体症状困扰预测。
结论：令人痛苦的症状的存在解释了在报告慢性疼痛的HTRs和没有疼痛的HTRs中心理健康差的显著比例。
