Fatigue, Sleep Problems, and Self-Efficacy Before and After Heart Transplantation: A 5 Year Follow-Up

Fatigue is a troublesome symptom after heart transplantation and is poorly studied in a long-term perspective. One hypothesis is that there is a strong relationship between fatigue, sleep problems, and self-efficacy, and that fatigue decreases self-efficacy. The aim of this study was to explore self-reported fatigue from the time on the waiting list to 5 years after heart transplantation and its association with self-efficacy and sleep problems.

In this multicenter, longitudinal cohort study 48 heart recipients, 12 women and 36 men with a median age of 57 years, were followed from pre-transplant to 5 years post-transplant. Three instruments were used: (1) the transplant-specific Organ Transplant Symptom and Well-Being Instrument (OTSWI), (2) the Swedish version of the Multi-Dimensional Fatigue Inventory (MFI), and (3) the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G).

Sleep problems decreased after transplantation, but after 3-5 years, there were no differences in comparison with pre-transplant. Self-efficacy improved for the whole group from pre-transplant up to 5 years after heart transplantation. General fatigue predicted self-efficacy.

Fatigue plays a pivotal role in self-efficacy after heart transplantation. It reduces self-efficacy due to causing uncertainty and should constitute a primary target for future interventions.