Pain, fatigue and well-being one to five years after lung transplantation - a nationwide cross-sectional study

Rationale and aimLittle is known about persistent pain after lung transplantation. Therefore, the aim was to present a multidimensional assessment of self-reported pain 1-5years after lung transplantation and its relationship with fatigue and transplant-specific well-being. MethodsThis nationwide, cross-sectional cohort study is part of the self-management after thoracic transplantation study. A total of 117 lung recipients, all White, who were due for their annual follow-up at one (n=35), two (n=28), three (n=23), four (n=20) and 5years (n=11) after lung transplantation were included. We used three instruments; the Pain-O-Meter (POM), which provides information about pain intensity, sensation, location and duration, the MFI-19 fatigue instrument and the Organ Transplant Symptom and Well-being Instrument (OTSWI). Permission to carry out this study was granted by the Regional Ethical Review Board in southern Sweden (D-nr 2014-124). ResultsThe prevalence of pain was 51% after 1year, 68% after 2years, 69.5% after 3years, 75% after 4years and 54.5% after 5years. Women experienced more pain than men. Lung recipients with pain reported lower well-being and higher symptom distress but were not more fatigued than those without pain. Study limitationsThe limitations of this study are due to the cross-sectional design. The recruitment of patients during the study period was probably affected by the different conditions regarding staffing at the outpatient lung transplant clinic in the two thoracic transplant centres in Sweden. The slightly different approach to the care of these patients in the pre, peri and postoperative setting contributes to the heterogeneity of the study population. ConclusionChronic bodily pain up to 5years after lung transplantation reduces perceived well-being. Lung recipients with pain report higher symptom distress than those without pain.