Quality of life, demoralization syndrome and health-related lifestyle in cardiac transplant recipients - a longitudinal study in Taiwan

Background: Quality of life is an outcome indicator after health care treatment, and the factors that affect quality of life change over time after heart transplantation. As such, quality of life as related to heart transplantation warrants further investigation. Aims: The purposes of this study were to compare different post-transplant times of cardiac transplant recipients in terms of their quality of life, demoralization syndrome and health-related lifestyle and to identify the predictors of quality of life in Taiwan. Methods: This longitudinal study, which used convenience sampling, was conducted in one medical center. Participants were divided into three groups (1, 2 and 3) based on post-transplant time. Four questionnaires, that is, demographic, quality of life, including a physical and mental component summary (PCS and MCS), demoralization and health-related lifestyle, were used to collect data at baseline and at three, six and 12 months. Hierarchical regression was used to identify the predictors of quality of life. Results: There were 99 participants, who were divided into three groups: Group 1 (n = 31), Group 2 (n = 29) and Group 3 (n = 39). The majority of participants were male, with a mean age of 53.68 years. In each group, fewer than half had good quality of life, and one-third had demoralization syndrome. Demoralization syndrome combined with post-transplant time, age, use of mechanical circulatory support during hospitalization and stress status accounted for 35.2% of PCS for all participants. Further, demoralization syndrome combined with age and religion accounted for 40.3% of MCS for all participants. Conclusions: The results indicated that quality of life, demoralization syndrome and health-related lifestyle were correlated over time. Demoralization was an independent predictor of quality of life.