The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients: A systematic review

Conway, Aaron, Schadewaldt, Verena, Clark, Robyn, Ski, Chantal, Thompson, David R., Kynoch, Kate, & Doering, Lynn (2014) The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients: A systematic review. European Journal of Cardiovascular Nursing, 13(2), pp. 108-115.

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Post-heart transplant psychological distress may both directly hinder physiological health as well as indirectly impact on clinical outcomes by increasing unhealthy behaviours, such as immunosuppression non-adherence. Reducing psychological distress for heart transplant recipients is therefore vitally important, in order to improve patients’ overall health and well-being but also clinical outcomes, such as morbidity and mortality. Evidence from other populations suggests that non-pharmacological interventions may be an effective strategy.


To appraise the efficacy of non-pharmacological interventions on psychological outcomes after heart transplant.


A systematic review was conducted using the Joanna Briggs Institute methodology. Experimental and quasi-experimental studies that involved any non-pharmacological intervention for heart transplant recipients were included, provided that data on psychological outcomes were reported. Multiple electronic databases were searched for published and unpublished studies and reference lists of retrieved studies were scrutinized for further primary research. Data were extracted using a standardised data extraction tool. Included studies were assessed by two independent reviewers using standardised critical appraisal instruments.


Three studies fulfilled the inclusion and exclusion criteria, which involved only 125 heart transplant recipients. Two studies reported on exercise programs. One study reported a web-based psychosocial intervention. While psychological outcomes significantly improved from baseline to follow-up for the recipients who received the interventions, between-group comparisons were not reported. The methodological quality of the studies was judged to be poor.


Further research is required, as we found there is insufficient evidence available to draw conclusions for or against the use of non-pharmacological interventions after heart transplant.

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5 citations in Web of Science®
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ID Code: 65459
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Transplant, Cardiac, Heart transplant, Anxiety, Depression, Quality of life, Systematic review
DOI: 10.1177/1474515113519519
ISSN: 1474-5151
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2013 The European Society of Cardiology
Deposited On: 19 Dec 2013 00:16
Last Modified: 12 Jul 2016 03:16

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