Liver transplantation (LT) has for decades been the most acceptable treatment for End-Stage Liver Disease (ESLD). Patient survival rates for LT are now approximately 91 % at one year, 77% at five years, and 59% at ten years post- LT. Furthermore, since LT has now been successful for several decades, there are a growing number of long-term survivors. Little is known about their quality of life (QOL). The aim of this thesis was to evaluate patient QOL and its correlates in new and long-term survivors following LT. A prospective longitudinal study of recent LT patients was conducted in tandem with a cross-sectional study of long-term LT survivors. Patients were recruited at King's College Hospital. New LT patients (N= 41) were recruited in hospital and were assessed at one month, three months, six months, and one year post-LT. Long-term survivors (N = 213) were recruited through the LT outpatient clinic. The questionnaire pack in both studies included measures of disease-specific and generic QOL, social support, optimism, emotional intelligence, anxiety, depression, and posttraumatic growth. Over the first year post-LT, patients experience improvements in physical QOL and disease-specific QOL, and decreases in anxiety. However, all patients reported impairment is physical QOL as compared to published UK results, yet no difference in mental QOL. Greater patient optimism and social support was associated with better QOL. There was an inverse relationship between anxiety and depression, and QOL scores. Patients experience a personal, positive growth post- LT, which is associated with greater emotional intelligence. The results of this thesis contribute to the understanding of QOL and psychological outcomes for patients over the first year post-LT, and in the long term. QOL varies over the first year post-LT, and patients benefit from social support and being optimistic. Similar to new LT recipients, long-term LT survivors have a significant impairment in their QOL compared with a UK sample. In both groups, clinicians need to continue monitoring patient QOL issues and anticipate that further patient support may be needed.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:578692 |
| Date | January 2011 |
| Creators | Walker, Erin Amanda |
| Publisher | University of Sheffield |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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