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Abstract SUMMARY Liver transplantation is perceived as the only effective treatment for patients with end-stage liver diseases and is considered as a procedure not only to save lives, but also to improve the quality of life (Luo et al., 2012). This procedure is necessary in patients who have sever acute or chronic liver failure, irreversible and progressive liver disease which doesn’t respond to alternative medical and surgical interventions (Adam, et al., 2006). Health-related quality of life (HRQOL) is a quantitative conversion of a patient’s self-assessment of his/her physical, functional, social, and psychological dimensions of life. It is a means of studying how a patient perceives his/her health status and other nonmedical aspects of his/her life (Bownik, & Saab, 2009). Aim of the Study: This study aimed to: 1. Assess health-related quality of life issues experienced by patients before and after liver transplantation. 2. Assess the factors affecting health-related quality of life issues before and after liver transplantation. Research Questions: 1. What are the health-related quality of life issues experienced by patients before and after liver transplantation? 2. What are the factors affecting health-related quality of life issues before and after liver transplantation? Summary 73 Methodology: Research design: A descriptive exploratory design was followed to achieve the aim of this study. Setting: This study was conducted at Ain Shams Center of Organ Transplantation (ASCOT) in Ain Shams Specialized Hospital which is affiliated to Ain Shams University. Subject: A Purposive sample of 30 adult patients, who were admitted at the center for liver transplantation, participated in the study. They were of with different educational levels. Tools of data Collection: Data for this study were collected using the following tools: A) Structured interview sheet (Appendix I): This tool was developed by the researcher in Arabic language after reviewing the related literature to assess patient’s characteristics (age, sex, level of education, marital status, occupation. etc), and factors affecting HRQOL e.g., disease severity and duration of illness. B) Short Form- 36 (SF-36) Questionnaires: This questionnaire was developed by John and Ware, (1996) to assess HRQOL. C) Euro Quality of life - 5 Dimensions (EQ-5D) Questionnaire: This tool was developed by Euro QOL group (1990) to assess HRQOL Summary 74 Results The main results of study revealed that: x The mean age for the patients included in the study was 49.27 ± 8.16, the majority of study subjects (86.67%) were males. Less than two thirds of study subjects (63.33%) have MELD score less than 18, 80.00% had the disease for more than 5 years. Most of the study subjects had liver cirrhosis (90.00%), and hepatitis C (93.33%). The minority had hepatitis B (10.00%) and were exposed to encephalopathy episodes (23.33%). All of the study subject (100%) underwent liver transplantation for the first time. x There was a highly statistically significant improvement in all dimensions of HRQOL after liver transplantation. Regarding Euro Quality of life (EQ-5D) scores, there was a highly significant improvement after liver transplantation in comparison with pre liver transplantation scores. x Before liver transplantation, there were significant negative correlations between all dimensions of quality of life and age except for role limitation due to emotional health and emotional wellbeing. As well, a significant negative correlation was detected between visual analogue scale (VAS) scores and age. There were statistically significant relations between some dimensions of HRQOL and monthly income, educational level and disease severity x Three months after liver transplantation, there were statistically significant relations between some dimensions of HRQOL and working, monthly income, and disease duration. Summary 75 Conclusion The present study concluded that: There is a highly statistically significant improvement in all dimensions of HRQOL one month and three months after liver transplantation in comparison with pre transplantation scores. The highest score in HRQOL before liver transplantation was for emotional wellbeing dimension; while at one month and three months after liver transplantation, it was for role limitation due to emotional health dimension. On the other hand, the least score in QOL before, one month and three months after liver transplantation was for role limitation due to physical health dimension. Age was affecting all dimensions of HRQOL, while working status, monthly income, educational level, disease severity, and disease duration affected only some dimensions of HRQOL. Recommendations Based on the previous results, the following recommendations are suggested: x Improving patient’s quality of life should be the main objective for nurses during their care of a liver transplant patient. x Using specific instruments to evaluate quality of life that report liver illness symptoms to provide more accurate information and better indicators to the extent of HRQOL impairment before and after liver transplantation. x Further studies are needed which deal with other factors that may affect HRQOL of transplanted patients, such as donor age, quality of the transplanted graft, post- transplant immunosuppressant medication types, episodes of rejection, and disease recurrence |