Uncertainty after heart transplantation. A new perspective on self-efficacy and self-management.
Ovisshet efter hjärttransplantation : ett nytt perspektiv på self-management och self-efficacy
Author
Summary, in English
Background
Self-management is the main concept constituting the foundation of follow-up care after heart transplantation.
Self-efficacy is a foundation of self-management. Little is known about heart recipients’ experiences in relation to
self-efficacy and self-management after heart transplantation.
Aim
The overall aim of this thesis was to explore uncertainty and self-efficacy as important aspects of the lived experience
of heart recipients one year after heart transplantation.
Methods
Both an inductive and a deductive approach have been used in combination with qualitative research methods.
The study group consisted of 14 patients (I and II) who were due for their one year follow-up after heart
transplantation. Interviews were performed and analysed by phenomenological hermeneutics (inductive) developed
by Lindseth & Norberg and directed content analysis (deductive) developed by Hsieh & Shannon.
Results
The meaning of uncertainty after heart transplantation involved: doubting survival, doubting the recovery process,
doubting one’s performance, struggling with close relationships, feeling abandoned and doubting the future. Uncertainty
emerges when the heart recipients are unable to ascribe meaning to illness-related events and might therefore be a
source of distress. Performance accomplishment, which comprises physical, social and mental aspects, was seen as
the main factor affecting self-efficacy after heart transplantation. Lack of performance accomplishment led to
disappointment and therefore our hypothesis was that self-efficacy after heart transplantation concerns balancing
expectations in accordance with realistic accomplishments.
Conclusions
Complications, setbacks and symptoms together with expectations are sources of uncertainty. Performance
accomplishment enables expectations to be met and might therefore constitute a source of uncertainty when
accomplishments are not achieved. Uncertainty can undermine performance and might thereby hamper selfefficacy
and self-management.
Self-management is the main concept constituting the foundation of follow-up care after heart transplantation.
Self-efficacy is a foundation of self-management. Little is known about heart recipients’ experiences in relation to
self-efficacy and self-management after heart transplantation.
Aim
The overall aim of this thesis was to explore uncertainty and self-efficacy as important aspects of the lived experience
of heart recipients one year after heart transplantation.
Methods
Both an inductive and a deductive approach have been used in combination with qualitative research methods.
The study group consisted of 14 patients (I and II) who were due for their one year follow-up after heart
transplantation. Interviews were performed and analysed by phenomenological hermeneutics (inductive) developed
by Lindseth & Norberg and directed content analysis (deductive) developed by Hsieh & Shannon.
Results
The meaning of uncertainty after heart transplantation involved: doubting survival, doubting the recovery process,
doubting one’s performance, struggling with close relationships, feeling abandoned and doubting the future. Uncertainty
emerges when the heart recipients are unable to ascribe meaning to illness-related events and might therefore be a
source of distress. Performance accomplishment, which comprises physical, social and mental aspects, was seen as
the main factor affecting self-efficacy after heart transplantation. Lack of performance accomplishment led to
disappointment and therefore our hypothesis was that self-efficacy after heart transplantation concerns balancing
expectations in accordance with realistic accomplishments.
Conclusions
Complications, setbacks and symptoms together with expectations are sources of uncertainty. Performance
accomplishment enables expectations to be met and might therefore constitute a source of uncertainty when
accomplishments are not achieved. Uncertainty can undermine performance and might thereby hamper selfefficacy
and self-management.
Department/s
Publishing year
2018
Language
English
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Document type
Licentiate thesis
Publisher
Lund University: Faculty of Medicine
Topic
- Medical and Health Sciences
Keywords
- Uncertainty in illness
- Self-efficacy
- Self-management
- Heart Transplantation
Status
Published
Research group
- Care in high technological environments
Supervisor
- Anna Forsberg
- Annette Lennerling
Defence date
2 March 2018
Defence time
09:00
Defence place
Hörsal 1, Health Science Centre, Baravägen 3 i Lund
Opponent
- Sofia Almerud (docent)