PedsCCM: Pediatric Critical Care Nursing Literature Reviews

Article Reviewed:

Hanton L. Caring for children awaiting heart transplantation: psychosocial implications. . Pediatric Nursing 1998: 24; 214-225

Reviewed by:

Eileen Briening RN MSN CRNP
Sinai Hospital of Baltimore
Baltimore, MD
ebrienin@sinai-balt.com

Posted 8/4/99

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Patients awaiting heart transplantation experience profound stress during the preoperative, perioperative and postoperative stages. The wait period during the preoperative stage is described as the most stressful time. The average waiting period ranges from 563 days for a Status 2 and 40 days for a Status 1 patient. The wait may begin at home for children in stable condition, while the child in deteriorating health are typically hospitalized. The Stress and Coping Model of Lazarus and Folkman (1984) can be used by nurses as a conceptual framework for addressing stressors of pediatric patients awaiting heart transplants and their families. A case study of a preadolescent child awaiting heart transplantation in a hospital outside the transplant center is reviewed. The psychosocial needs are assessed and met using a multidisciplinary approach. Interventions were initiated such as encouraging the patient to personalize her room, and scheduling time for relaxation, play, homework and socializing. This case also looks at the stresses incurred by unit nurses trying to coordinate and direct the childÕs care.