title: Life after a lung transplant: a balance of joy and challenges.
abstract: OBJECTIVE
  To describe patients' experiences throughout the first four months post-lung transplant.
  
  
  BACKGROUND
  Health professionals are familiar with the fact that patients' average survival after a lung transplant is about seven years and that 74% of these patients reject new organs within the first two years. By contrast, knowledge of these patients' perspectives after lung transplantation is scant.
  
  
  METHODS
  A qualitative study was conducted between May 2013-May 2014 in which 26 interviewees participated - four months post-transplant - based on a semistructured interview guide. The data were inductively analysed using a content thematic approach within a phenomenological and hermeneutic frame.
  
  
  RESULTS
  The main findings in the study reveal that (1) having a lung transplant is an overwhelming experience, which for some patients includes (2) troubling physical and psychological challenges. The interviewees were happy to get another chance to live, although some of them suffered from medical side effects, postoperative complications and psychological problems. When asked about the future, interviewees stated that life could be described as (3) a balance of joy and challenges. They had received a new chance in life and were eager to fulfil their life hopes and dreams. At the same time, they were worried about the future. Having a lung transplant implies rules that have to be followed. What are the healthy choices they are supposed to make? And will there be a tomorrow?
  
  
  CONCLUSIONS
  Having a lung transplant is described as an overwhelming experience because of the improvement in the physical function of the body. Patients were grateful to family, friends and healthcare professionals for supporting them. The first four months post-transplantation were described as both physically and psychologically challenging. Interviewees were aware of the prognosis for patients following lung transplantation. They expressed feelings of worry and insecurity but still had hopes and dreams.
  
  
  CONCLUSIONS
  The patients are troubled by both physical and psychological challenges after lung transplantation. Several areas call for interventions from healthcare professionals during the early post-transplant period.
authors.affiliation: Copenhagen University Hospital, Rigshospitalet, the Heart Center, Copenhagen, Denmark.
authors.forename: Jytte
authors.initials: J
authors.lastname: Graarup
authors.affiliation: Copenhagen University Hospital, Herlev Hospital, Herlev, Denmark.
authors.forename: Elin Lindberg
authors.initials: EL
authors.lastname: Mogensen
authors.affiliation: Copenhagen University Hospital, Rigshospitalet, the Heart Center, Copenhagen, Denmark.
authors.forename: Malene
authors.initials: M
authors.lastname: Missel
authors.affiliation: Copenhagen University Hospital, Rigshospitalet, the Heart Center, Copenhagen, Denmark.
authors.forename: Selina Kikkenborg
authors.initials: SK
authors.lastname: Berg
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology; D011184:Postoperative Period; D036301:Qualitative Research; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology; D013997:Time Factors; D055815:Young Adult
keywords: hermeneutic-phenomenological approach; lung transplantation; nursing; patient perspective