Psychosocial adjustment to orthotopic liver transplantation in 266 recipients

Abstract

Although the survival rate of patients undergoing orthotopic liver transplantation (OLT) is highly satisfactory, one of the most important objectives for liver transplantation teams at the present time is to achieve the best possible quality of life and psychosocial functioning for these patients after transplantation. We present the preliminary results of a study designed to determine which domains of psychosocial functioning are most affected in liver transplant recipients, and to examine the factors associated with poorer adjustment after OLT, using a utility-based standardized measure. Patients who had undergone liver transplant more than 12 months previously were eligible. They were administered the Psychosocial Adjustment to Illness Scale (PAIS), and they provided the answers themselves. Multivariate regression models showed that attitudes toward health care were poorer in women (␤ ‫؍‬ 0.916, P < .001), in patients who were employed at the moment of transplantation (␤ ‫؍‬ 0.530, P ‫؍‬ .032), and in patients of lower social class (␤ ‫؍‬ 0.722, P ‫؍‬ .026) than in men, unemployed patients, and patients of higher social class. Sexual functioning was worse in women (␤ ‫؍‬ 0.907, P ‫؍‬ .001) and older patients (␤ ‫؍‬ 0.999, P < .001) than in men or younger patients. Psychological distress was higher in women (␤ ‫؍‬ 0.981, P ‫؍‬ .001) than in men, and lower in currently employed patients (␤ ‫؍‬ -0.937, P ‫؍‬ .001) than in the unemployed. Only gender remained significantly associated with the total PAIS score (␤ ‫؍‬ 0.969, P < .001), with women showing a poorer overall psychosocial adjustment to OLT. In conclusion, there seems to be no doubt that liver transplantation improves quality of life, but special attention should be paid to female recipients, who seem to have more difficulty than their male counterparts in adjusting to the psychosocial consequences of the procedure. (Liver Transpl 2004;10:228 -234.)

Quality of life after liver transplantation. A systematic review

“…The differences were partially corrected after adjustment for educational level. A similar result was reported by Spanish investigators who reported that psychosocial adjustment after LT was rated higher in male compared to female recipients [27].…”

Quality of Life and Physical Activity after Liver Transplantation. Literature Review.

“…The differences were partially corrected after adjustment for educational level. A similar result was reported by Spanish investigators who reported that psychosocial adjustment after LTx was reported higher in males compared to female recipients (Blanch et al, 2004). Similarly, in research by Kotarska et al HRQOL was significantly worse in female patients in the majority of the SF-36 domains (Kotarska et al, 2014).…”

Sexual health after orthotopic liver transplantation

“…There are few, if any, studies of sexual health in the liver transplant literature worldwide, and we are unaware of any specific studies of this subject matter conducted in North America. A recent study 5 emphasizes the need for specific socioculturally generalizable studies. This study, conducted in Barcelona, included sexual health, but only as a domain within a larger psychosocial study using the Psychosocial Adjustments to Illness Scale.…”