More Than a New Heart: Psychological Adjustment and Quality of Life Following Heart Transplantation, a Mixed-Methods Study.

INTRODUCTION

Heart transplantation (HTx) offers life-saving treatment for advanced heart failure. While physical recovery is well-documented, psychological recovery and health-related quality of life (HRQOL) during early post-discharge remains less well understood. This mixed-methods study aims to describe changes in depression, anxiety, and HRQOL in HTx recipients from hospital discharge to three months, integrated with qualitative perspectives.

METHODS

The study enrolled 18 HTx recipients. Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), and the 36-Item Short Form Health Survey (SF-36) were administered at both time points. For scaled responses, change and associations were evaluated using paired t-tests and correlations; semi-structured interviews were examined using thematic analysis. Findings were integrated with a convergent matrix approach.

RESULTS

Participants (mean age 49 ± 15.2) reported no significant changes in depression or anxiety at 3 months. HRQOL improved significantly in SF-36 physical functioning (p = 0.001), physical role limitations (p = 0.007), bodily pain (p < 0.001), and social functioning (p < 0.001). Qualitative findings characterized emotional recovery as early vulnerability and gradual adjustment.

CONCLUSIONS

HRQOL improved significantly after discharge, while psychological recovery was unchanged. Integrated findings identified medication-induced mood changes and social isolation as barriers to the strengthening of emotional well-being during early recovery.