More Than a New Heart: Psychological Adjustment and Quality of Life Following Heart Transplantation, a Mixed‐Methods Study

INTRODUCTION: Heart transplantation (HTx) offers life-saving treatment for advanced heart failure. While physical recovery is well-documented, psychological recovery and health-related quality of life (HRQOL) during early post-discharge remains less well understood. This mixed-methods study aims to describe changes in depression, anxiety, and HRQOL in HTx recipients from hospital discharge to three months, integrated with qualitative perspectives. METHODS: The study enrolled 18 HTx recipients. Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), and the 36-Item Short Form Health Survey (SF-36) were administered at both time points. For scaled responses, change and associations were evaluated using paired t-tests and correlations; semi-structured interviews were examined using thematic analysis. Findings were integrated with a convergent matrix approach. RESULTS: Participants (mean age 49 ± 15.2) reported no significant changes in depression or anxiety at 3 months. HRQOL improved significantly in SF-36 physical functioning (p = 0.001), physical role limitations (p = 0.007), bodily pain (p < 0.001), and social functioning (p < 0.001). Qualitative findings characterized emotional recovery as early vulnerability and gradual adjustment. CONCLUSIONS: HRQOL improved significantly after discharge, while psychological recovery was unchanged. Integrated findings identified medication-induced mood changes and social isolation as barriers to the strengthening of emotional well-being during early recovery.