Health transition after lung transplantation - a grounded theory study

• Published in: Journal of clinical nursing Vol. 25; no. 15-16; pp. 2285 - 2294
• Main Authors: Lundmark, Martina, Erlandsson, Lena-Karin, Lennerling, Annette, Almgren, Matilda, Forsberg, Anna
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.08.2016; Wiley Subscription Services, Inc
• Subjects: Adult; Clinical Medicine; Daily occupation; Everyday life; Female; Grounded Theory; Health; Health Status; Health Transition; Health-related quality of life; Humans; Klinisk medicin; Lung Transplantation; Lungmedicin och allergi; Lungs; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Nursing; Occupational therapy; Qualitative study; Quality of Life; Recovery of Function; Respiratory Medicine and Allergy; Trajectory; Transition; Transitions; Transplants & implants; Treatment Outcome; Sweden; daily occupation; everyday life; grounded theory; health transition; health; qualitative study; health-related quality of life; lung transplantation; trajectory; transition
• ISSN: 0962-1067; 1365-2702; 1365-2702
• DOI: 10.1111/jocn.13269

Aims and objectives To investigate lung recipients' process of transition from prior the transplantation to one year afterwards, as well as what their main concerns are and how they deal with these concerns. Background During the last three decades, lung transplantation has been established as an effective treatment for patients with end‐stage pulmonary disease. Towards the end of the 20th century, the concept of survival expanded to also include improving health‐related quality of life (HRQoL). Although many studies have been published regarding lung recipients' HRQoL, aspects of health and everyday life remain understudied. Lung transplantation demands some kind of transition. However, very little is known about this transitional process. Design A qualitative inductive approach using Grounded Theory (GT) was used. Methods A total of ten adult males and five adult females (n = 15) with a mean age of 55 years were included in the study and interviewed one year after transplantation. The open‐ended interviews were digitally recorded and transcribed verbatim after each interview. The analysis of the material was performed consistent with Charmaz contructivistic approach of GT. Results The core category Reconstructing daily occupations summarises a process wherein the generated GT is present through four main categories: Restricting, Regaining, Reorganising and Enriching. The process of reconstructing daily occupations is necessary to regain health. Conclusions A trajectory of health transition is evident, starting pretransplant with the lung disease and severe illness and proceeding at least up to one year after the transplantation with experienced health. Relevance to clinical practice The result enables a unique possibility to enhance the lung recipients' striving for everyday life and thereby promote health. There is a need for change in the existing multidisciplinary transplant team to also include an occupational therapist to support and guide the lung recipients in changing their occupational patterns.