Caring for children awaiting heart transplantation: psychosocial implications

Heart transplantation presents an extremely stressful life transition for pediatric recipients and their families. The waiting period of the preoperative stage has been described as the most stressful aspect of the process. The stress and coping model of Lazarus and Folkman (1984) can be used as a conceptual framework for addressing stressors of pediatric transplant patients and their families. A case study of a preadolescent child awaiting heart transplantation in a hospital outside of a transplant center highlights common concerns, including feelings of isolation, depression, boredom, hopelessness, helplessness, exhaustion, lack of privacy, financial burdens, role strain, and family disruption. Psychosocial needs can be assessed and met, using a multidisciplinary approach. Because the preoperative stage can be stressful for nurses as well, the case study also explores the struggles of unit nurses trying to coordinate and manage the patient's care.