Date Available

4-29-2025

Year of Publication

2025

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Holly Stith

Committee Member

Dr. Joy Coles

Faculty

Dr. Lee Anne Walmsley

Faculty

Dr. Andrew Makowski

Abstract

Background: Heart transplant recipients are at an elevated risk of experiencing depressive symptoms compared to the general population. Those with depression post-transplant face increased complications, e.g., infection, organ rejection, prolonged hospitalization, and higher mortality rates. However, specific psychotherapeutic interventions tailored for heart transplant recipients remain limited. Nevertheless, there is substantial evidence supporting the effectiveness of various interventions for adults with heart failure, a condition frequently diagnosed in these patients. This suggests that successful strategies for managing depressive symptoms in heart failure patients could be adapted for heart transplant recipients.

Purpose: The purpose of this project was to evaluate the effect of a brief, nurse-led cognitive behavioral therapy (CBT) intervention aimed at reducing the severity of depressive symptoms in heart transplant recipients. The primary aims were to: 1) Determine the presence and severity of depressive symptoms among inpatient adult heart transplant recipients at an academic health center utilizing the Patient Health Questionnaire-9 (PHQ-9) screening tool. 2) Evaluate the effectiveness of a brief nurse-led CBT intervention explicitly designed for heart transplant recipients at reducing the severity of the patients’ depressive symptoms.

Methods: A quasi-experimental, one-group pretest/posttest design utilized a convenience sample of inpatient adult heart transplant recipients. The participants completed the PHQ-9 for depression screening prior to a 30-minute nurse-led CBT session, and again via telephone 2-4 weeks post-intervention. Data analysis was conducted using non-parametric tests, including the Wilcoxon signed-rank test, Mann-Whitney U test, Kruskal-Wallis H test, and Spearman’s correlation, with a significance of p = 0.05.

Results: The average pre-intervention PHQ-9 score was 9.83 (SD = 5.981), compared to a post-intervention score of 4.33 (SD = 2.251). The change between pre- and post-intervention scores was statistically significant (Z = -2.207, p = 0.027), suggesting a decrease in depressive symptoms. Although sociodemographic factors did not significantly correlate with PHQ-9 scores, there was a strong positive correlation between age and pre-intervention scores (r(6) = 0.841, p = 0.036).

Conclusions: This project supports the feasibility and effectiveness of nurse-led CBT in alleviating depressive symptoms among hospitalized heart transplant recipients. Further research is necessary to develop structured psychotherapeutic interventions tailored to this vulnerable population.

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