title: 'A post-transplant person': Narratives of heart or lung transplantation and intensive care unit delirium.
abstract: Exploring patients' narratives can lead to new understandings about perceived illness states. Intensive Care Unit delirium is when people experience transitory hallucinations, delusions or paranoia in the Intensive Care Unit and little is known about how this experience affects individuals who have had a heart or lung transplant. A total of 11 participants were recruited from two heart and lung transplant services and were invited to tell their story of transplant and Intensive Care Unit delirium. A narrative analysis was conducted and the findings were presented as a shared story. This shared story begins with death becoming prominent before the transplant: 'you live all the time with Mr Death on your shoulder'. Following the operation, death permeates all aspects of dream worlds, as dreams in intensive care 'tunes into the subconscious of your fears'. The next part of the shared story offers hope of restitution; however, this does not last as reality creeps in: 'I thought it was going to be like a miracle cure'. Finally, the restitution narrative is found to be insufficient and individuals differ in the extent to which they can achieve resolution. The societal discourse of a transplant being a 'gift', which gives life, leads to internalised responsibility for the 'success' or 'failure' of the transplant. Participants describe how their experiences impact their sense of self: 'a post-transplant person'. The clinical implications of these findings are discussed.
authors.affiliation: Lancaster University, UK K.Flynn@Lancaster.ac.uk.
authors.forename: Katy
authors.initials: K
authors.lastname: Flynn
authors.affiliation: Lancaster University, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Daiches
authors.affiliation: Wythenshawe Heart and Lung Transplant Unit, UK.
authors.forename: Zoey
authors.initials: Z
authors.lastname: Malpus
authors.affiliation: Wythenshawe Heart and Lung Transplant Unit, UK.
authors.forename: Nizar
authors.initials: N
authors.lastname: Yonan
authors.affiliation: Harefield Heart and Lung Transplant Service, UK.
authors.forename: Melissa
authors.initials: M
authors.lastname: Sanchez
mesh_terms: D000328:Adult; D000368:Aged; D003693:Delirium / Q000453:epidemiology* / Q000523:psychology; D004739:England / Q000453:epidemiology; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D033262:Narration
keywords: death dying and bereavement; experiencing illness and narratives; mental health; narrative analysis