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Onghena L, Berrevoet F, Vanlander A, Van Vlierberghe H, Verhelst X, Hoste E, Poppe C. Illness cognitions and health-related quality of life in liver transplant patients related to length of stay, comorbidities and complications. Qual Life Res 2022; 31:2493-2504. [DOI: 10.1007/s11136-022-03083-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 10/19/2022]
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Demir B, Bulbuloglu S. Perceived body image and distress after liver tansplantation in recipients. Transpl Immunol 2021; 69:101483. [PMID: 34688881 DOI: 10.1016/j.trim.2021.101483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study's aim was to determine the relationship between the perception of self-body image and the level of distress in patients who had liver transplantation surgery. METHOD This study was performed as a descriptive and cross-sectional study with the attendance of 120 liver transplant patients hospitalized in the liver transplant center of a training and research hospital. Self-body image was measured based on the Body Image Questionnaire (BIQ) on a scale of 40 (lowest) to 200 (highest) with the optimal BIQ score of 135-200. The level of distress was evaluated by the Distress Thermometer (DT) on a scale of 0 (None) to 10 (High). The data analysis was performed with the IBM Statistical Package for the Social Sciences Statistics 25. RESULTS According to the data attained, 35.8% of the patients were 55 years old or older, 56.7% were male, and 61.7% were married. The mean BIQ score among all tested patients was 81.85 ± 27.31, and this was considered as a low level of self-image. The mean DT score of the patients was 5.45 ± 2.72, which indicated relatively high levels of distress in the transplant recipients. Comparing these two values together (BIQ + DT) by regression analysis, we found a moderate negative relationship between self-body image (BIQ) and distress (DT) in the patients (r: -0.391, p < 0.001). Accordingly, when the distress levels of the patients decreased, their perceptions of self-body image increased. CONCLUSION Even if their liver transplant operation is successful, the problems of the recipients after transplantation do not completely disappear. Liver transplant recipients should be helped in coping with their condition effectively. Patients undergoing liver transplantation should be provided with psychosocial and emotional support.
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Affiliation(s)
- Bilsev Demir
- Division of Surgical Nursing, Nursing Department, Health Sciences Faculty, Malatya Turgut Özal University, Malatya, Turkey.
| | - Semra Bulbuloglu
- Division of Surgical Nursing, Nursing Department, Health Sciences Faculty, Istanbul Aydın University, Istanbul, Turkey.
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Cristin DJ, Forman LM, Jackson WE. Beyond Survival: Targeting Health-Related Quality of Life Outcomes After Liver Transplantation. Clin Liver Dis (Hoboken) 2021; 17:359-364. [PMID: 34136142 PMCID: PMC8177828 DOI: 10.1002/cld.1059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/14/2020] [Accepted: 10/25/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- David J. Cristin
- Division of Gastroenterology and HepatologyUniversity of Colorado Anschutz Medical CenterAuroraCO
| | - Lisa M. Forman
- Division of Gastroenterology and HepatologyUniversity of Colorado Anschutz Medical CenterAuroraCO
| | - Whitney E. Jackson
- Division of Gastroenterology and HepatologyUniversity of Colorado Anschutz Medical CenterAuroraCO
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Moayed MS, Ebadi A, Khodaveisi M, Nassiri Toosi M, Soltanian AR, Khatiban M. Factors influencing health self-management in adherence to care and treatment among the recipients of liver transplantation. Patient Prefer Adherence 2018; 12:2425-2436. [PMID: 30510406 PMCID: PMC6248226 DOI: 10.2147/ppa.s180341] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Liver transplantation is the global treatment of end-stage liver diseases. Since the patients' survival rate has been improved, the patient may experience reductions in physical, cognitive, and psychosocial functions after liver transplantation influencing their adherence to care and treatment. The transplant survival is complex and patients' adherence to care and treatment should be considered when health care providers make decisions regarding treatment. This qualitative study aimed to explore factors influencing health self-management in adherence to care and treatment among the recipients of care and treatment. METHODS In this study, 23 interview sessions were carried out with a total 18 patients, 2 family members and 3 transplantation team members from May to November 2017. The patients were selected using the purposive method from both genders, with a various age range and initial diseases leading to liver transplantation, and time passed from liver transplantation. A semi-structured interview guide was developed based on literature review and pilot interviews. The participants were asked to describe their experiences of self-management behaviors in adherence to treatment and care. The data were analyzed using a conventional content analysis method and managing via the MAXQDA-10 software. RESULTS Two themes were developed during data analysis as "self-regulation" and "self-care". "Self-regulation" consisted of "intentionally changing", "positively thinking", "information seeking", "problem-solving", "past knowledge transferring", and "self-controlling". "Self-care" had three sub-themes "shift to independence", "vigilance", and "self-care support". CONCLUSION The participants perceived the health self-management in adherence to care as a set of factors related to "self-regulation" and "self-care" behaviors. "Self-regulation" is required to create a balance in life. Also, "self-care" efforts can help with maintaining and improving patients' health.
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Affiliation(s)
- Malihe Sadat Moayed
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Ebadi
- Nursing Education, Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Masoud Khodaveisi
- Chronic Diseases (Home Care) Research Center, Community Health Nursing Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohssen Nassiri Toosi
- Internal Medicine, Hepatologist, Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Soltanian
- Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahnaz Khatiban
- Mother and Child Care Research Center, Medical-Surgical Nursing Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran,
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De Pasquale C, Veroux M, Fornaro M, Sinagra N, Basile G, Gozzo C, Santini R, Costa A, Pistorio ML. Psychological perspective of medication adherence in transplantation. World J Transplant 2016; 6:736-742. [PMID: 28058225 PMCID: PMC5175233 DOI: 10.5500/wjt.v6.i4.736] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/25/2016] [Accepted: 10/27/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To identify the risk factors and the post-transplant psychological symptoms that affect adherence to therapy in a population of kidney transplant recipients.
METHODS The study examined the psychological variables likely responsible for the non-adherent behavior using a psychological-psychiatric assessment, evaluation of the perception of patients’ health status, and an interview regarding the anti-rejection drug therapy assumption. The study included 74 kidney transplant recipients.
RESULTS Individuals with a higher level of education and more years since transplantation showed better mental balance. Regarding gender, women appeared to be less adherent to therapy. Further, the years since transplantation adversely affected the proper pharmacological assumption. Adherence to therapy did not significantly change with the mental health index.
CONCLUSION The biopsychosocial illness model provides a conceptual frame of reference in which biological, psychological, and social aspects take on the same importance in the adherence to treatment protocols. For effective management, it is necessary to understand the patients’ personal experiences, their assumptions about the disease, health status perception, and mood, and to identify any “barriers” that could cause them to become noncompliant.
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Lei JY, Yan LN, Wang WT, Zhu JQ, Li DJ. Health-Related Quality of Life and Psychological Distress in Patients With Early-Stage Hepatocellular Carcinoma After Hepatic Resection or Transplantation. Transplant Proc 2016; 48:2107-11. [PMID: 27569954 DOI: 10.1016/j.transproceed.2016.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/25/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of our study was to compare the post-operative health-related quality of life in patients with small hepatocellular carcinoma (HCC; within the Milan criteria) after liver resection or liver transplantation. METHODS From August 2000 to December 2010, 207 patients were diagnosed with early HCC within the Milan criteria. We divided these patients into 2 groups according to their curative schedule: the liver transplantation group (n = 95) and the liver resection group (n = 110). We compared the baseline characteristics of these 2 groups of patients, after which we focused on comparing the post-operative health-related quality of life (HRQOL) and psychological outcome in these 2 groups. RESULTS The demographics of the patients in the 2 groups were similar, and there were no significant differences except for higher family income in the transplantation group (P = .002).With long-term follow-up, there were no significant differences in the 8 domains of the HRQOL and the 9 domains of the psychological outcome measure between the 2 groups. Both the transplantation and resection groups exhibited good outcomes in both HRQOL and psychological outcome measures. CONCLUSIONS Several years after operation, early-stage HCC patients who underwent liver transplantation or resection had similar long-term HRQOL and psychological outcomes.
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Affiliation(s)
- J Y Lei
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China; Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - L N Yan
- Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - W T Wang
- Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - J Q Zhu
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - D J Li
- The Medical Department, West China Hospital of Sichuan University, Chengdu, China.
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Pegum N, Connor JP, Young RM, Feeney GF. Psychosocial functioning in patients with alcohol-related liver disease post liver transplantation. Addict Behav 2015; 45:70-3. [PMID: 25644590 DOI: 10.1016/j.addbeh.2015.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 12/29/2014] [Accepted: 01/12/2015] [Indexed: 12/20/2022]
Abstract
Emotional and role functioning difficulties are associated with chronic alcohol use and liver disease. Little is known about prospective changes in psychological and psychosocial functioning following orthotopic liver transplantation (OLT) amongst patients with alcoholic liver disease (ALD). We aimed to assess the functioning of this patient group post liver transplantation. Comprehensive psychosocial assessment of depression (Beck Depression Inventory [BDI]), anxiety (State-Trait Anxiety Inventory-Form X [STAI]) and psychosocial adjustment (Psychosocial Adjustment to Illness Scale-Self-Report version [PAIS-SR]) was conducted with 42 ALD patients available for pre and post OLT testing. Dependence severity was assessed by the Brief Michigan Alcoholism Screening Test (bMAST). Significant reductions in average anxiety and depression symptoms were observed 12-months post-OLT. Significant improvements in psychosocial adjustment to illness were also reported. Patients with higher levels of alcohol dependence severity pre transplant assessment improved comparably to those with lower levels of dependence. In summary, the study found that OLT contributed to reducing overall levels of mood and anxiety symptoms in ALD patients, approximating general (non-clinical) population norms. Psychosocial adjustment also improved significantly post liver transplantation.
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Cicognani E, Mazzoni D, Totti V, Roi GS, Mosconi G, Nanni Costa A. Health-related quality of life after solid organ transplantation: the role of sport activity. PSYCHOL HEALTH MED 2014; 20:997-1004. [PMID: 25531821 DOI: 10.1080/13548506.2014.993404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The aim of the study was to investigate the effects of sport activity on health-related quality of life (HRQoL) of solid organ transplant recipients participating in sports competitions. A group of 168 sportive transplanted patients (STP), a group of 97 nonsportive transplanted patients (NSTP), and a group of 152 sportive healthy controls (SHC) were compared on the eight scales of the SF-36 questionnaire. STP and NSTP reported significantly lower scores than SHC on the physical functioning scale. STP did not differ from SHC in the Role-Physical, General Health, and Vitality scales, while NSTP reported significantly lower scores. STP obtained higher scores than NSTP and SHC on Mental Health. Among STP, the effect of quantity of sport activity was significant on General Health and Role Emotional, with more sport activity associated with higher HRQoL. Organ failure and post-transplant therapies may have negative consequences on HRQoL. Sports activities and participation in sports competitions can reduce this impact, improving general and psychological functioning of solid organ transplant recipients.
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Affiliation(s)
- Elvira Cicognani
- a Department of Psychology , University of Bologna , Via Berti Pichat, 5, 40126 Bologna , Italy
| | - Davide Mazzoni
- a Department of Psychology , University of Bologna , Via Berti Pichat, 5, 40126 Bologna , Italy
| | - Valentina Totti
- b No Profit Foundation for the Advancement of Organ and Tissue Transplantation , Passaggio Gaudenzio 1, 35131 Padua , Italy
| | - Giulio Sergio Roi
- c Education and Research Department Isokinetic Medical Group , v. di Casteldebole 8/4, 40132 Bologna , Italy
| | - Giovanni Mosconi
- d Nephrology and Dialysis Unit , Morgagni-Pierantoni Hospital , Via Carlo Forlanini, 34, 40121 Forlì , Italy
| | - Alessandro Nanni Costa
- e Italian National Transplant Center, National Institute of Health , Viale Regina Elena 299, 00161 Roma , Italy
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McGregor LM, Dickson A, Flowers P, Hayes PC, O'Carroll RE. Reclaiming their lives: the decision-making process in living liver donation--an interpretative phenomenological case study analysis of one couple. Psychol Health 2014; 29:1373-87. [PMID: 24991986 PMCID: PMC4192859 DOI: 10.1080/08870446.2014.940950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Adult-to-adult living liver donation (LLD) is a controversial procedure due to the risk to the healthy donor. The decision to proceed with LLD is an important, yet under-researched area. This study aims to explore the decision-making process of the donor and recipient independently, and within the donor-recipient dyad. DESIGN A longitudinal, qualitative analysis of the LLD decision from the perspective of a LLD donor-recipient dyad. METHODS In-depth interviews were conducted with the donor and recipient separately on three occasions: pre LLD, six weeks post and six months post LLD. Transcripts were subject to interpretative phenomenological analysis. RESULTS During the pre-LLD interviews, a series of intra- and interpersonal negotiations were reported as both the donor and recipient grappled to make a decision about LLD. Following the decision, the focus then centred on the consequences of the decision and making sense of unanticipated outcomes. By six months post LLD, both were able to reflect on adapting to the changes their decision had ultimately caused. CONCLUSIONS This case study offers a unique insight into the risk assessment and decision-making demands of LLD and the results can help support future LLD candidates.
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Schipper K, Abma TA, Koops C, Bakker I, Sanderman R, Schroevers MJ. Sweet and sour after renal transplantation: a qualitative study about the positive and negative consequences of renal transplantation. Br J Health Psychol 2013; 19:580-91. [PMID: 23826640 DOI: 10.1111/bjhp.12057] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 04/25/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This qualitative study investigated the renal patients' experience of positive and negative consequences of transplantation, as well as the strategies they use to adapt to the transplantation. DESIGN AND METHODS A qualitative design (30 participants in total), using individual interviews (18 participants) and two focus groups (12 participants in total), was used. RESULTS The results showed that patients experienced a wide range of positive and negative emotions, in particular, guilt, gratefulness, and fear, partly as a result of their normative persuasions. Normative persuasions may transform inherent positive emotions into negative emotions and subsequent maladaptive behaviour. Not only physical limitations but also physical improvements were found to be related to the experience of negative emotions. Finally, the results indicated that patients mainly used adaptive coping strategies to adjust to life after transplantation, such as looking for opportunities, setting different priorities, making own choices, trying to maintain control, taking good care of oneself, and appreciating other things in life. CONCLUSIONS This study offers several new insights regarding the range of experiences of renal patients after transplantation. Health professionals are invited to pay more attention to the full range of positive and negative experiences following transplantation, including the existence of normative persuasions. Health professionals may assist renal patients by helping them to recognize and acknowledge both positive and negative emotions and to encourage the use of more beneficial coping strategies. STATEMENT OF CONTRIBUTION What is already known on this subject? The quality of life (QoL) of renal patients significantly improves after transplantation but the post-transplant QoL is lower compared with the QoL in healthy populations. Patients on dialysis and those who have received a donor kidney tend to use mainly emotion-focused coping strategies. What does this study add? This study offers several new insights regarding experiences of renal patients after transplantation: Patients experience a range of positive and negative emotions like guilt, gratefulness, and fear. Emotions are partly a result of normative persuasions. Persuasions may transform positive emotions into negative emotions and maladaptive behaviour. Physical limitations and improvements can due to the persuasions lead to negative emotions. Patients mainly use adaptive coping strategies.
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Affiliation(s)
- Karen Schipper
- Department of Medical Humanities, EMGO+ Institute, VU University Medical Center (Vumc), Amsterdam, The Netherlands
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