BACKGROUND Cellular rejection is most common 3-6 months after heart transplantation while chronic rejection, that is, cardiac allograft vasculopathy and malignancy are the most common causes of death in heart-transplant recipients beyond the third year after transplantation. However, the heart transplantation recipient's perceived threat of graft rejection has never been explored. AIM The aim was to explore perceived threat of the risk of graft rejection and its relationship to psychological wellbeing, fatigue, health literacy, adherence and self-efficacy 1-5 years after heart transplantation. METHODS In a nationwide, cross-sectional study that constituted part of the Self-management after thoracic transplantation project, 79 heart recipients (68% men and 32% women with a mean age of 52.6 years) were investigated after one year (n=28), two years (n=17), three years (n=11), four years (n=17) and five years (n=6). The instruments used were: the Perceived Threat of the Risk of Graft Rejection, the Psychological General Well-being, Self-efficacy for Managing Chronic Disease, the Multidimensional Fatigue Inventory, the Newest Vital Sign and the Basel Assessment of Adherence to Immunosuppressive Medication Scale. RESULTS Twenty-eight per cent of the heart transplantation recipients perceived graft rejection as a serious threat. Intrusive anxiety was low and 37% perceived the threat of the risk of graft rejection as being beyond their control. Heart transplant recipients with high level of fatigue and low psychological well-being reported stronger intrusive anxiety and less control. CONCLUSION A perceived threat of the risk of graft rejection is present in the everyday lives of heart transplantation recipients and is strongly related to overall psychological well-being.

中文翻译：

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心脏移植后移植排斥的恐惧——一项全国性的横断面队列研究

背景 细胞排斥最常见于心脏移植后 3-6 个月，而慢性排斥，即心脏同种异体移植物血管病变和恶性肿瘤是心脏移植受者在移植后 3 年后最常见的死亡原因。然而，从未探索过心脏移植受者感知到的移植排斥威胁。目的 目的是探讨移植排斥风险的感知威胁及其与心脏移植后 1-5 年的心理健康、疲劳、健康素养、依从性和自我效能的关系。方法 在一项全国性横断面研究中，该研究构成了胸腔移植后自我管理项目的一部分，一年后对 79 名心脏受者（68% 男性和 32% 女性，平均年龄 52.6 岁）进行了调查（n=28 ), 两年（n=17）、三年（n=11）、四年（n=17）和五年（n=6）。使用的工具是：移植物排斥风险的感知威胁、心理健康、管理慢性病的自我效能、多维疲劳量表、最新生命体征和巴塞尔对免疫抑制药物依从性评估量表。结果 28% 的心脏移植受者认为移植排斥是一种严重威胁。侵入性焦虑很低，37% 的人认为移植排斥风险的威胁超出了他们的控制范围。具有高度疲劳和低心理健康状况的心脏移植受者报告了更强的侵入性焦虑和更少的控制。