title: Holistic care for pediatric organ transplant recipients and their families during their dark postoperative recovery stage in the hospital.
abstract: BACKGROUND
  This study explored the difficulties in caring for pediatric organ transplant recipients (POTR) and their families during dark recovery experiences (DRE) in the hospital from the perspectives of Taiwan organ transplant health professionals (OTHP).
  
  
  METHODS
  A qualitative design was used, with a purposive sample of OTHP including OT surgeons (OTS) and nursing groups. Data were collected by thorough face-to-face interviews and were analyzed using content analysis.
  
  
  RESULTS
  Fifty-five subjects (39 female, 16 male) participated in this project. They included 15 OTS and 40 nurses. The nurses included registered nurses (n = 27), nurse practitioners (n = 5), and assistant or head nurses (n = 8). Their ages ranged from 25 to 66 (mean = 38.4) years old. Thirty-eight (69%) had college education, and 17 (31%) had graduate education. Their OT careers ranged from between 3 to 40 (mean = 23.8) years for OTS, and 0.5 to 15 (mean = 4.10) years for the OT nursing group. Five types of caring difficulties were reported: (1) threat of OT failure, (2) work overload, (3) insufficient collaboration within interdisciplinary teams due to incongruent surgical and nursing opinions, (4) poor communication between OTHP and POTR, and (5) lack of competent professional OT care.
  
  
  CONCLUSIONS
  The following suggestions were made to help relieve the OTHPs' stress in providing holistic care for POTR and their families during DRE: (1) increasing the amount of experienced OT manpower and professional communication liaisons, (2) providing systematic on-the-job interdisciplinary case seminars and OT workshops, and (3) enhancing the POTR's mental health care and helping manage their distress of DRE.
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taichung, Taiwan.
authors.forename: F C
authors.initials: FC
authors.lastname: Yang
authors.affiliation: Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: F Jong
authors.initials: FJ
authors.lastname: Shih
authors.affiliation: Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: P H
authors.initials: PH
authors.lastname: Tseng
authors.affiliation: Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wangp@ntu.edu.tw.
authors.forename: S S
authors.initials: SS
authors.lastname: Wang
authors.affiliation: National Yang-Ming University, and Institute of Clinical and Community Health Nursing, Chayi, Taiwan; Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan. Electronic address: ppaul456tw@yahoo.com.tw.
authors.forename: F Jin
authors.initials: FJ
authors.lastname: Shih
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006694:Holistic Health; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology; D016377:Organ Transplantation / Q000009:adverse effects / Q000451:nursing*; D010348:Patient Care Team; D010820:Physicians / Q000523:psychology; D036301:Qualitative Research; D011787:Quality of Health Care; D020127:Recovery of Function; D013315:Stress, Psychological / Q000523:psychology*; D013624:Taiwan; D013997:Time Factors; D066027:Transplant Recipients / Q000523:psychology*; D016896:Treatment Outcome; D016526:Workload