Assessment of Factors Related to Adherence to Treatment in Liver Transplantation Candidates

Quality of life, religiosity, and anxiety and depressive symptoms in liver transplantation candidates

OBJECTIVE

To evaluate quality of life, religiosity and anxiety and depressive symptoms in liver transplant candidates.

METHOD

An epidemiological and cross-sectional study carried out with liver transplant candidates attended at the outpatient clinic of a University Hospital from 2014 to 2016.

RESULTS

Fifty (50) patients with a mean age of 52.5 years old participated in the study, predominantly male (58.0%), having access to primary education (48.0%), Model for End-Stage Liver Disease between 10-19 and having viral hepatitis as the main etiology. They presented an average quality of life score (4.1), high intrinsic religiosity index (5.6) and the presence of anxiety (52.0%) and depressive symptoms (48.0%). It was possible to observe an association between religiosity and quality of life in the worry domain, with higher non-organizational religiosity leading to higher quality of life; anxiety and depressive symptoms were not associated with quality of life and religiosity. However, patients with higher levels of education were more likely to present depressive symptoms.

CONCLUSION

The analysis of quality of life and religiosity was significant, reinforcing the need for the care team to consider religiosity as a coping strategy for the disease.

The Portuguese Version of the Immunosuppressant Therapy Adherence Scale (ITAS) among Liver Transplant Recipient Patients: Translation and Psychometric Properties

INTRODUCTION AND AIM

Transplant recipients are chronically ill patients who rely on medical treatment throughout life to achieve positive results. Despite that, medication nonadherence after liver transplantation is extremely common. The self-report, one of several methods for measuring adherence, is easy to apply and low cost. Thus, this study aims to translate and validate the Immunosuppressant Therapy Adherence Instrument (ITAS) in Brazilian Portuguese for liver transplant recipients.

MATERIAL AND METHODS

A total of 139 liver transplant recipients were selected from a general hospital, who were assessed by using the Portuguese version of ITAS. The scale was translated based on the model proposed by Wild, et al. and its psychometric properties were assessed.

RESULTS

The average Cronbach's α coefficient was 0.830. ITAS and Basel Assessment of Adherence with Immunosuppressive Medications Scale (BAASIS) presented significant correlation, with a Spearman's ρ coefficient = 0.300 (S = 309,580; p < 0.001). The area under the receiver operating characteristics (ROC) curve was 0.638 (95% CI: 0.557 - 0.715). Factor analysis results indicated that the carelessness factor model was the optimal model, and the factor "feeling worse" was the lowest.

CONCLUSION

The Portuguese version of ITAS has adequate psychometric properties to measure adherence to immunosuppressant therapy.