Abstract This is a critique of the qualitative research article named "somebody else''s heart inside me: a descriptive study
of
psychological problems after heart transplantation". The study that was conducted in Scotland on thirty-five men and seven women that had a heart transplant. The study''s aim was to discover the psychological problems that those patient experienced. The findings of that study showed that those patients thought a lot of the donor and if by getting the new heart their personality may change. They had mixed feelings about the donation, guilt feelings that the donor had to die for them to get the new heart, and gratefulness to the donors'' families for the donation. These findings will help the medical staff to teach the patients how to cope with the situation and by this decrease the psychological strains those patients will have. Introducing / Background of the problem. Heart transplantation is no more a rare treatment for patient with a terminal heart disease. Previous researches show that also heart transplant changes the physical life quality of the recipients it has a different impact on their mental life quality. This study was funded by a scholarship from the Greek State Foundation. Conducting it were: Evridiki Kaba, PhD, BN, RN, general hospital of Volos, Volos Greece, David R. Thompson,PhD, RN, FRCN, FESC, department of health seience, university of York, York, UK, Philip Burnard, PhD, RN, Deborha Edwards, MPhil,BSc, school of nursing and midwifery studies, university of Wales college of medicine, Cardiff, UK, and Eleni Theodosopoulou, PhD, BSc,RN, school of health sciences, facultity of nursing, department, of surgery nursing, Athens university, Atens, Greece.The whole introduction of the study explains the problem, and other researchers'' point of view. The importance of this study lays in the fact that by understanding the mental pressures that those heart recipients undergo, the medical staff will be able to help them and ease off some of the mental pressure, so the aim of the study was to investigate what do heart recipients feel emotionally and mentally after their heart transplant. Review of the literature. The authors of this study reviewed nineteen studies that dealt with heart transplants and the psychological impact they have on the recipients. Those studies produced the findings that showed that after the heart transplant also most of them could lead almost a normal active lifestyle most of them suffered from emotional or psychological problems for a long period after they got their new heart. The reviewed studies showed that some grieved about their own heart loss and some about the donor who had to die so they could get the new heart. Those studies brought up the possibility that this may be the reason for the mental distress. Those studies helped the investigators as they based their findings on those found in the other studies. The authors identified the gaps found in the literature they reviewed. They "blamed" the fact that the little research that has dealt with how recipient perceive their transplant experience and the impacts it has on their lives, and the limited research conducted on the psychological problems of heart transplant recipient after the operation is what keeps the significant gaps in the knowledge of those problems. They got logical support for their study as some concluded their findings stating that more studies are needed to deepen and extend the understanding in this area. They even got support for their study from the consultant and coordinator of the heart transplant clinic. Theoretical framework. The authors used for heir study interviews with patients who had undergone heart transplant and the theoretical and conceptual framework for it was based on the ground theory qualitative approach. The authors to select the
participants used sampling theory. Formulation of research questions. Reading the article, we do not find any mentioning of research s that were presented to the study''s participants, but the authors say that the question emerged from the interviews and they "moved from general to particular". The Authors explain that some times they had to ask general questions in the opening of the interviews to invoke the remembrance of the thoughts those patients had for the period after their operation, or they presented some questions to the participants in order for them to illuminate the information they shared with the researchers. The authors do say that they had asked participants to remark on the reported experience of others. Documentation rigor / descriptive vividness. The steps in the study were clearly stated. In each step they explained how and why they did what they did reinforcing it with theories used and given by the other researchers the reviewed. As to the findings'' validation with participants, we get the notion that they did it as in the article, in the paragraph titled data collection; they say they "ask them to comment on other patients'' reported experiences". The researchers, under the paragraph findings, do give a full vivid description of the emotions and thoughts of the participants'' regarding psychological aspects that became clear in during interviews by citation the stories told by the heart transplant recipients. Procedural rigor. Grounded theory is the design used for this study as this method enabled them to draw out of the interviews, held with the heart transplant recipients, the characterization of an effect that arose from those interviews and produce from it a theory that would explain that effect. The study was done in Scotland in a medical center that its name was not mentioned in the study. Participating in this study were 42 heart transplant recipients that underwent the surgery between two month and a year before the study began. The participants were 35 males and 7 females aged 32 to 61 years that visited the outpatient''s clinic. The participants had to volunteer for participating in the study. The Local Research Committee was looking for such study therefore approving it. In order to get a degree of trustworthiness the interviewer, long before the study started, spent time in the hospital and clinic, became acquainted with the patients and that gave them the feeling they can trust him. The data was collected as the patients visited the outpatients'' clinic, there they were interviewed for 30 to 45 minutes. The interview was taped and could have been done by everyone as long as they had enough knowledge to draw out the conclusions needed for the study. The data that was collected were the stories told by heart transplant recipients regarding their feelings, thoughts, self-image and problems they experienced mainly after the surgery and how the cope with them. To interpret the data the researcher used comparison analysis. Transcription of those recorded stories produced identification forming the categories and concepts that in turn produced the theoretical notes that allowed the researcher to make out what the main problem of the study''s participants is. Three coding types were used in this study, the open the axial and the selective coding. Exactly how they did the verification of the data interpretation is not written, but as they explain in that paragraph method or techniques used by others for analyzing data we can assume the did the same. Results / Discussion of results. (application to practice) The results of this study showed that four things occupy the mind and soul of heart transplant recipient after they get their new heart. In the study, the authors highlight only the theme they call "somebody else''s heart inside me" and the derivations that arose from that theme. For each of them they show by quoting from the patient interviews. Those findings supplied them with precious comprehension of the intricacy of how the heart transplant recipients'' perceive the period after their operation. Medic