Skip to main content

Advertisement

SpringerLink
Log in

Health-related quality of life and psychological correlates in patients listed for liver transplantation

  • Published:
Hepatology International Aims and scope Submit manuscript

Abstract

Purpose

Given the increasing waiting time for liver transplantation, and the amount of possible stressors associated with it, assessment of psychological well-being and health-related quality of life (HRQoL) in these patients is warranted in order to optimize pretransplant care.

Patients and methods

Patients with chronic liver disease (n = 32) awaiting transplantation completed a series of questionnaires measuring HRQoL, depression, anxiety, coping, and self-efficacy. Comparisons were made with other patients with liver disease with and without cirrhosis, and a healthy norm population. Relationships among these psychological variables were explored and subgroup analyses were performed to assess possible differences in coping strategies.

Results

Compared to other patients with liver disease without cirrhosis, liver transplant candidates had statistically significantly lower HRQoL scores on the subscales of physical functioning (P < 0.001) and general health (P < 0.001). Their HRQoL did not differ from patients with liver disease with cirrhosis. Overall, patients awaiting liver transplantation had significantly reduced HRQoL (P < 0.001) and increased depression scores (P < 0.001) compared to healthy controls. Levels of depression, anxiety, self-efficacy, and coping did not differ between liver transplant candidates and other patients with liver disease. Depression correlated significantly with HRQoL. Patients without depression made significantly more use of active coping strategies than patients with elevated depression levels.

Conclusions

Patients awaiting liver transplantation are not experiencing worse physical and psychological HRQoL than other liver patients with cirrhosis of the liver. Therefore, there is currently no indication to increase the level of psychosocial care for liver transplant candidates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Cupples SA, Nolan MT, Augustine SM, Kynoch D. Perceived stressors and coping strategies among heart transplant candidates. J Transpl Coord 1998;8(3):179–87.

    PubMed  CAS  Google Scholar 

  2. Jalowiec A, Grady KL, White-Williams C. Stressors in patients awaiting a heart transplant. Behav Med 1994;19(4):145–54.

    Article  PubMed  CAS  Google Scholar 

  3. Porter RR, Krout L, Parks V, Aaronson NK. Perceived stress and coping strategies among candidates for heart transplantation during the organ waiting period. J Heart Lung Transplant 1994;13(1 Pt 1):102–7.

    PubMed  CAS  Google Scholar 

  4. Karam V, Castaing D, Danet C, Delvart V, Gasquet I, Adam R, et al. Longitudinal prospective evaluation of quality of life in adult patients before and one year after liver transplantation. Liver Transpl 2003;9(7):703–11.

    Article  PubMed  Google Scholar 

  5. De Bona M, Ponton P, Ermani M, Iemmolo RM, Feltrin A, Boccagni P, et al. The impact of liver disease and medical complications on quality of life and psychological distress before and after liver transplantation. J Hepatol 2000;33(4):609–15.

    Article  PubMed  Google Scholar 

  6. Lahteenmaki A, Hockerstedt K, Kajaste S, Huttunen M. Quality of life before and after liver transplantation: experiences with 7 patients with primary biliary cirrhosis in a 2-year follow-up. Transpl Int 1992;5(Suppl 1):S705–7.

    PubMed  Google Scholar 

  7. Ratcliffe J, Longworth L, Young T, Bryan S, Burroughs A, Buxton M. Assessing health-related quality of life pre- and post-liver transplantation: a prospective multicenter study. Liver Transpl 2002;8(3):263–70.

    Article  PubMed  Google Scholar 

  8. Shih FJ, Hu RH, Ho MC, Lin HY, Lin MH, Lee PH. Changes in health-related quality of life and working competence before and after liver transplantation. Transplant Proc 2000;32(7):2144–8.

    Article  PubMed  CAS  Google Scholar 

  9. Burra P, De Bona M, Canova D, Painter L. Longitudinal prospective study on quality of life and psychological distress before and one year after liver transplantation. Acta Gastroenterol Belg 2005;68(1):19–25.

    PubMed  CAS  Google Scholar 

  10. Beilby S, Moss-Morris R, Painter L. Quality of life before and after heart, lung and liver transplantation. N Z Med J 2003;116(1171):U381.

    PubMed  Google Scholar 

  11. Streisand RM, Rodrigue JR, Sears SF Jr, Perri MG, Davis GL, Banko CG. A psychometric normative database for pre-liver transplantation evaluations. The Florida cohort 1991–1996. Psychosomatics 1999;40(6):479–85.

    PubMed  CAS  Google Scholar 

  12. Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002;21(2):271–92.

    Article  PubMed  Google Scholar 

  13. Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998;51(11):1055–68.

    Article  PubMed  CAS  Google Scholar 

  14. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36), II: psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31(3):247–63.

    Article  PubMed  CAS  Google Scholar 

  15. Razavi D, Gandek B. Testing Dutch and French translations of the SF-36 Health Survey among Belgian angina patients. J Clin Epidemiol 1998;51(11):975–81.

    Article  PubMed  CAS  Google Scholar 

  16. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36), I: conceptual framework and item selection. Med Care 1992;30(6):473–83.

    Article  PubMed  Google Scholar 

  17. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–71.

    PubMed  CAS  Google Scholar 

  18. Beck AT, Steer RA, Brown GK, van der Does AJW. Handleiding bij de BDI-II-NL. Enschede, the Netherlands: Ipskamp; 1996.

    Google Scholar 

  19. Beck AT, Steer R, Garbin M. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988;8(1):77–100.

    Article  Google Scholar 

  20. Richter P, Werner J, Heerlein A, Kraus A, Sauer H. On the validity of the Beck Depression Inventory. A review. Psychopathology 1998;31(3):160–8.

    Article  PubMed  CAS  Google Scholar 

  21. van der Ploeg HM. Handleiding bij de Zelf Beoordelings Vragenlijst. Lisse, the Netherlands: Swets & Zeitlinger BV; 2000.

    Google Scholar 

  22. Leganger A, Kraft P, Roysamb E. Perceived self-efficacy in health behavior research: conceptualisation, measurement and correlates. Psychol Health 2000;15:51–69.

    Google Scholar 

  23. Scholz U, Gutiérrez-Doña B, Sud S, Schwarzer R. Is perceived self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess 2002;18(3):242–51.

    Article  Google Scholar 

  24. Schwarzer R, Jeruzalem M. Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M, editors. Measures in health psychology: a user’s portfolio. Causal and control beliefs. Windsor, England: NFER-NELSON; 1995. p. 35–7.

    Google Scholar 

  25. Carver CS. You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med 1997;4(1):92–100.

    Article  PubMed  CAS  Google Scholar 

  26. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56(2):267–83.

    Article  PubMed  CAS  Google Scholar 

  27. Kleijn WC, van Heck GL, van Waning A. Ervaringen met een Nederlandse bewerking van de COPE copingvragenlijst. De COPE-Easy. Experiences with a Dutch adaptation of the COPE coping questionnaire: the COPE-Easy. Gedrag Gezond Tijdschr Psychol Gezond 2000;28(4):213–26.

    Google Scholar 

  28. Beck AT, Steer RA, Brown BW Jr, van der Does AJW. Beck Depression Inventory II, NL Handleiding. Lisse: Harcourt Test Publishers; 1996.

  29. Sankoh AJ, Huque MF, Dubey SD. Some comments on frequently used multiple endpoint adjustment methods in clinical trials. Stat Med 1997;16(22):2529–42.

    Article  PubMed  CAS  Google Scholar 

  30. Goetzmann L, Wagner-Huber R, Klaghofer R, Muellhaupt B, Clavien PA, Buddeberg C, et al. Waiting for a liver transplant: psychosocial well-being, spirituality, and need for counselling. Transplant Proc 2006;38(9):2931–6.

    Article  PubMed  CAS  Google Scholar 

  31. Shen BJ, Myers HF, McCreary CP. Psychosocial predictors of cardiac rehabilitation quality-of-life outcomes. J Psychosom Res 2006;60(1):3–11.

    Article  PubMed  Google Scholar 

  32. Hofer S, Benzer W, Alber H, Ruttmann E, Kopp M, Schussler G, et al. Determinants of health-related quality of life in coronary artery disease patients: a prospective study generating a structural equation model. Psychosomatics 2005;46(3):212–23.

    Article  PubMed  Google Scholar 

  33. Bechdolf A, Klosterkotter J, Hambrecht M, Uda H. Determinants of subjective quality of life in post acute patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2003;253(5):228–35.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Erasmus MC, ’s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Jolie J. Gutteling & Robert A. de Man

  2. Department of Medical Psychology and Psychotherapy, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands

    Jolie J. Gutteling, Jan J. V. Busschbach & Anne-Sophie E. Darlington

Authors
  1. Jolie J. Gutteling
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert A. de Man
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan J. V. Busschbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne-Sophie E. Darlington
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jolie J. Gutteling.

Additional information

Communicated by Shiv Kumar Sarin, M.D.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gutteling, J.J., de Man, R.A., Busschbach, J.J.V. et al. Health-related quality of life and psychological correlates in patients listed for liver transplantation. Hepatol Int 1, 437–443 (2007). https://doi.org/10.1007/s12072-007-9035-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12072-007-9035-0

Keywords

Search

Navigation