From the waiting list to the transplanted heart: a qualitative approach to emotions, feelings, and coping strategies

Abstract

Introduction Living with a complex disease such as heart failure (HF) can influence the functional and emotional capacity of individuals, compromising their quality of life. Furthermore, it is a progressive disease that can result in the final route of treatment, which is heart transplantation (HT), and the patient suffers an impactful change in health and disease status that can generate different emotions and feelings. A stressful factor can interfere with the way an individual deals with situations and this can result in negative behavior that harms themselves, their quality and meaning in life. Understanding emotions, and feelings and being able to deal with emotions are fundamental practices for coping with the disease and maintaining quality of life. Objective To identify the emotions, feelings, and coping strategies of patients who are on the waiting list for an HT and those who have already received the graft. Method Qualitative and exploratory research was conducted with 3 patients on the waiting list and 3 HT patients undergoing outpatient follow-up in a Brazilian public hospital. The Symbolic Interactionism was used as a theoretical framework. Data collection was carried out through a semi-structured interview with the following triggering questions: "How do you feel when you think about Heart Transplantation?", and "What do you usually do to deal with these emotions and feelings?", "Is the way you deal with these emotions ideal for you?" The interview was recorded in audio, and transcribed in full and the data was subjected to content analysis consisting of 03 phases: I) Pre-exploration; II) Selection of analysis units; III) Categorization and subcategorization. Results The emotions mentioned by patients on the HT waiting list were fear, anger, and surprise and the feelings were hope, melancholy, and disappointment. The coping strategies of this group were religious belief, support from family and friends, or even introspection and resignation to the disease. Heart transplant patients reported emotions such as joy and sadness, and feelings such as gratitude and loneliness. The beliefs, the presence of family and friends, psychiatric support, and carrying out work activities were reported as ways of dealing with loneliness and sadness. Regarding self-perception of emotional management, both groups reported an adequate approach when they can rely on beliefs/family/friends. Conclusion Patients on the waiting list or who have already undergone an HF experience a duality of emotions and feelings characterized by fear, anger, surprise, joy, sadness, hope, melancholy, disappointment, gratitude, and loneliness, respectively. These findings contribute to the development of new tools that enable specific management of these emotions and feelings that emerge in patients who experience the context of HF.