الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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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
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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
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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
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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