SYMPTOMS OF ACUTE COMPLICATIONS AFTER LUNG TRANSPLANT

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The majority of lung transplant recipients experience improvement in the symptoms of their chronic pulmonary condition following lung transplantation, but are faced with the specter of new symptoms that invariably develop due to the devastating complications of rejection and infection. Clinicians are aware of the signs of these complications, and a plethora of studies have been published describing their incidence and impact. However, the precise characteristics and influencing factors of symptoms that cause distress, interfere with performance, or forewarn of impending complications are unknown. The purpose of this study is to describe the symptoms of acute complications after lung transplant and to identify the influencing factors. Methodological triangulation will e used to describe the symptom experience. Recipients will complete a symptom inventory and be interviewed to obtain their description of the symptoms and influencing factors they experience at intervals that coincide with evaluations for episodes of acute complications. Quantitive measures of physiological factors (pulmonary function, rejection, and infection), situational factors (time after transplant, immunosuppression regimen), and psychological factors (anxiety, depression) will be obtained at the same time intervals to determine their influence on symptomatology. Matrix analyses of qualitative and quantitative data will be performed to reveal factors that influence the symptom experience. The Theory of Unpleasant Symptoms provides a theoretical basis which nurses use to identify symptoms and their influencing factors, and design and evaluate interventions aimed at reducing the manifestations of symptoms and improving patient outcomes. Knowledge of the symptom experience of lung transplant recipients will provide the foundation for nurses to study the effects of interventions designed to detect and manage symptoms associated with acute complications after lung transplant.