title: Dark-recovery experiences, coping strategies, and needs of adult heart transplant recipients in Taiwan.
abstract: OBJECTIVE
  The aim of this project was to identify the dark-recovery experiences (DRE) that adult heart transplant recipients (AHTRs) perceived as causing the most suffering after heart transplantation (HT). In artition, we sought to explore the stage-specific difficulties, coping strategies, and helpers for transplant recipients DRE in Taiwan.
  
  
  METHODS
  A qualitative design was employed using a sample group of patients with DRE. Retrospective data collected by face-to-face in-depth interviews were subjected to content analysis.
  
  
  RESULTS
  A total of 20 AHTRs (16 men, 4 women) participated in this research. Their ages ranged from 32-70 years (mean, 46.95 years). Their post-HT timeframe ranged from 3 months-2.10 years. The subjects reported DRE the across preoperative intensive care unit (ICU), postoperative floor unit, and even after the hospital discharge stages. Four major difficulties during DRE were reported: (1) becoming a burden for families (all stages); (2) unfamiliar with medical protocols, environment, and policy (ICU stage); (3) mental and physical discomforts caused by the invasive examinations and unstable health condition (post-ICU to postdischarge stages); and (4) sense of uncertainty about health progression and quality of life in the future (post-ICU to postdischarge stages). Four coping strategies were used for DRE: (1) asking religious support (all stages); (2) changing mindsets and taking positive attitudes to live with difficulties (ICU to postdischarge stages); (3) setting goals for health maintenance and recovery (post-ICU to postdischarge stages); and (4) planning to look for an appropriate job in the future (postdischarge stages). Families and religious persons were cited as helpers (all stages), as well as health professionals (ICU to postdischarge stages), other AHTRs (post-ICU to postdischarge stages), and the social welfare systems (postdischarge stages).
  
  
  CONCLUSIONS
  DRE, coping strategies, and related helpers in Taiwan were systematically explored in this project. With this information, the transplantation team will be empowered to provide better care for AHTRs during their most vulnerable time.
authors.affiliation: Department of Nursing, Cardinal Tien College of Healthcare & Management Yilan Campus, and Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C S
authors.initials: CS
authors.lastname: Lin
authors.forename: S S
authors.initials: SS
authors.lastname: Wang
authors.forename: C L
authors.initials: CL
authors.lastname: Chang
authors.forename: F J
authors.initials: FJ
authors.lastname: Shih
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001290:Attitude; D003422:Critical Care / Q000523:psychology; D004777:Environment; D005190:Family / Q000523:psychology; D005260:Female; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012067:Religion; D012189:Retrospective Studies; D013624:Taiwan