PSYCHOSOCIAL ASPECTS OF QUALITY OF LIFE OF HEPATIC TRANSPLANT RECEIVERS

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Original Article • Texto contexto - enferm. 27 (2) • 2018 • https://doi.org/10.1590/0104-070720180003730016 copy

PSYCHOSOCIAL ASPECTS OF QUALITY OF LIFE OF HEPATIC TRANSPLANT RECEIVERS¹ 1 Article extracted from the dissertation – Quality of life after liver transplantation at a reference center in northeastern Brazil, presented at the Postgraduate Program in Nursing of the Pharmacy, Dentistry and Nursing School, Universidade Federal do Ceará (UFC), in 2014.

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ABSTRACT

Objective:

to assess the psychosocial dimension of patients’ quality of life before and after a hepatic transplantation.

Method:

descriptive, cross-sectional study of quantitative approach, with 150 patients submitted to a liver transplantation being monitored from the sixth month, in the outpatient clinic of a reference center in hepatic transplantation. The data collection was carried out through an instrument with sociodemographic/clinical data and the Liver Disease Quality of Life questionnaire. The descriptive statistical analysis, Student’s t-test for comparison of domain means, and Games-Howell for multiple comparisons have been used.

Results:

there was improvement in the post-transplant quality of life in the four domains evaluated (<0.0001),with higher scores for the domains: health distress (55.5 vs 87.9) and stigma of hepatic disease (58.6 vs 93.7).

Conclusion:

the study has demonstrated that patients submitted to a liver transplantation had a significant improvement in the perception of quality of life regarding the psychosocial dimension, being more perceptive in the areas of health distress and stigma of hepatic disease.

DESCRIPTORS:
Liver transplantation; Quality of life; Health assessment; Hepatic insufficiency; Psychosocial impact; Nursing

Aspects of the domain Quality of social interaction	%
Aspects of the domain Quality of social interaction	All the time	Most of the time	Sometimes	Rarely	Never
Before
Isolated yourself from people.	2,0	10,7	17,3	0,7	69,3
Was affectionate with people.	14,7	34,7	30,0	17,3	3,3
Was angry at people.	2,7	28,7	30,7	20,0	18,0
Asked unreasonable things to your friends or family members.	-	4,7	14,0	4,0	77,3
Was a very communicative person.	35,3	34,0	16,0	13,3	1,3
After
Isolated yourself from people.	-	0,7	2,0	2,0	95,3
Was affectionate with people.	26,0	46,7	24,0	2,0	1,3
Was angry at people.	-	2,0	26,7	39,3	32,0
Asked unreasonable things to your friends or family members.	-	0,7	0,7	0,7	98,0
Was a very communicative person.	48,7	40,7	5,3	4,0	1,3

Aspects of the domain	%
Aspects of the domain	All the time	Most of the time	Sometimes	Rarely	Never
Before
Do you feel discouraged by your liver disease?	2.7	26.7	22.7	4.7	43.3
Do you feel frustrated because of your liver disease?	2.7	21.3	19.4	9.3	47.3
Do you worry about your liver disease?	19.3	36.0	22.7	10.7	11.3
Do you feel depreciated because of your liver disease?	8.0	24.0	12.7	8.0	47.3
After
Do you feel discouraged by your liver disease?	1.3	-	6.7	3.3	88.7
Do you feel frustrated because of your liver disease?	1.3	-	4.0	1.3	93.3
Do you worry about your liver disease?	2.0	10.0	27.3	18	42.7
Do you feel depreciated because of your liver disease?	-	0.7	3.3	3.3	92.7

Aspects of the domain Loneliness	%
Aspects of the domain Loneliness	All the time	Most of the time	Sometimes	Rarely	Never
Before
Have you had company?	4,0	2,7	6,7	2,0	84,7
Have you had someone to count on?	2,0	2,7	5,3	0,7	89,3
Have you felt abandoned?	-	6,0	8,0	1,3	84,7
Have you felt isolated from the others?	0,7	9,3	9,3	2,7	78,0
Were you able to find company when you needed?	88,0	4,7	4,0	2,7	0,7
After
Have you had company?	4,0	2,0	2,0	2,7	89,3
Have you had someone to count on?	1,3	0,7	2,7	3,3	92,0
Have you felt abandoned?	-	1,3	0,7	2,0	96,0
Have you felt isolated from the others?	-	1,3	1,3	2,0	95,3
Were you able to find company when you needed?	93,3	4,7		-	0,7

Aspects of the domain Stigma of hepatic disease	%
Aspects of the domain Stigma of hepatic disease	All the time	Most of the time	Sometimes	Rarely	Never
Before
Some people avoid me because of my disease	26,7	8,7	0,7	3,3	60,7
I feel ashamed because of my appearance.	32,7	7,3	-	0,7	59,3
I avoid exposing myself because of my liver disease.	31,3	8,0	0,7	4,7	55,3
Some people feel uncomfortable in my presence because of my liver disease.	20,0	12,0	3,3	4,7	60,0
My illness makes me feel out of place in public.	22,7	11,3	1,3	2,0	62,7
I feel harmed and incomplete because of my liver disease.	54,7	14,0	0,7	2,0	28,7
After
Some people avoid me because of my disease.	0,7	3,3	2,6	0,7	92,7
I feel ashamed because of my appearance.	0,7	1,3	-	1,3	96,7
I avoid exposing myself because of my liver disease.	1,3	2,7	-	3,3	92,7
Some people feel uncomfortable in my presence because of my liver disease.	1,3	2,7	1,3	2,0	92,7
My illness makes me feel out of place in public.	-	-	-	2,0	98,0
I feel harmed and incomplete because of my liver disease.	7,3	14,0	-	2,7	76,0

LDQOL	Pre-transplantation	Post-transplantation
Domains	Average ± D.P.		P
Social interaction	69,0 ± 18,9	83,8 ± 11,0	<0,0001
Health distress	55,5 ± 28,8	87,9 ± 15,5	<0,0001
Loneliness	90,1 ± 18,7	95,9 ± 12,5	<0,0001
Stigma of hepatic disease	58,6 ± 33,0	93,7 ± 11,4	<0,0001

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] Correspondence: Maria Isis Freire de Aguiar, Address: Rua: Alexandre Baraúna, 1115,, 60.430-160 - Rodolfo Teófilo, Fortaleza, CE, Brazil. E-mail: isis_aguiar@yahoo.com.br