Effects of a Support Group Intervention on Physical, Psychological, and Social Adaptation of Liver Transplant Recipients.

OBJECTIVES: Liver transplant recipients must adapt to a new life after transplant. We report the effects of a support group on physical and psychosocial adaptation of liver transplant recipients. MATERIALS AND METHODS: The study used a quasi-experimental design, comparing an intervention group and a control group. Data were collected between January 2011 and May 2012 with 73 liver transplant recipients. A patient identification form, Modified Transplant Symptom Occurrence and Symptom Distress Scale - 58, and SF-36 were used for data collection. The intervention group attended support group meetings, while the control group received a routine follow-up. Data were analyzed with t test and The Repeated Measures ANOVA with 1 between-group factor. RESULTS: The results indicated that the support group intervention increases physical, psychological, and social adaptation of liver transplant recipients. Specifically, this effect of the support group was accrued after support group intervention and decreased 3 months after intervention. CONCLUSIONS: A support group intervention can have a positive effect on liver transplant recipients' physical, psychological, and social adaptations.

Immunosuppressive Medication Adherence, Therapeutic Adherence, School Performance, Symptom Experience, and Depression Levels in Patients Having Undergone a Liver Transplant During Childhood.

OBJECTIVES: This study sought to investigate immunosuppressive medication adherence, therapeutic adherence, school performance, symptom experiences, and depression levels of patients having undergone liver transplant during childhood. MATERIALS AND METHODS: We performed a retrospective, cross-sectional, case-controlled study to compare the depression levels of subjects with those of their healthy peers. Data were collected between June 23, 2014, and July 10, 2014, from 0- to 18-year-old patients having undergone a liver transplant between 1996 and 2014 (n = 27; the participant's mean age, 17.59 y [SD = 4.29, min-max = 8-28 y]). The mean score for the immunosuppressant therapy adherence was 11.18. To collect the data, the Demographic and Clinical Characteristics Form, Immunosuppressant Therapy Adherence Scale, Therapeutic Regimen Adherence Assessment Questionnaire, School Performance Assessment Questionnaire, Modified Transplant Symptom Occurrence and Symptom Distress Scale-58, and Beck Depression Inventory were used. To analyze the data, descriptive statistics (frequencies, mean, and standard deviation), Mann-Whitney U test, and ridit scoring were used. RESULTS: While the rate of adherence with clinical appointments was 55.5%, it was 33.3% with the diet (prescribed regimen) and 44.4% with exercise. While 33.3% of the participants repeated a grade or were held back, 44.4% of them missed more than 20 school days. Of the symptoms, the recipients mostly experienced anxiety, restlessness, nervousness, fatigue, and difficulty in concentrating. The patients' mean depression score was 7.77 when they were compared to their healthy peers, the difference was not statistically significant (P > .05). CONCLUSIONS: In our study, the recipients' adherence with immunosuppressive therapy and clinical appointment was high. This study will provide data for the literature about pediatric liver transplant recipients' adherence with diet and exercise, and physiological and psychological symptoms such as fatigue and anxiety.

Validation and adaptation of the Modified Transplant Symptom Occurrence and Symptom Distress Scale-59 Items Revised into Turkish.

CONTEXT: The Modified Transplant Symptom Occurrence and Symptom Distress Scale-59 Items Revised (MTSOSD-59R) is a validated self-reported scale assessing patients' subjective experiences of adverse effects of immunosuppressants. It has been reported that the scale should be adapted and validated before it is used in patients of a different cultural (Brazilian, Dutch, German, French, Hindi, Italian, Spanish, and Swedish) background. OBJECTIVE: To validate and adapt the MTSOSD-59R for use in Turkish transplant recipients. MATERIALS AND METHODS: This cross-sectional study was performed between March 2010 and February 2011, and included 180 liver and kidney transplant recipients treated in 2 university hospitals in western Turkey. In addition, 180 healthy control participants were recruited from a community health service. Data were collected by using a demographic and clinical characteristics scale (MTSOSD-59R) and the Beck Depression Inventory. Items were translated in a culturally sensitive way by using forward-backward translation. Content validity was evaluated by using the content validity index. Ridit analysis and descriptive statistics helped to describe symptom experience in our population, and Mann Whitney U testing was used to compare patients versus healthy controls, depressed versus nondepressed patients, and male versus female patients for validity purposes. Split-half reliability analysis was used. RESULTS: The content validity index was perfect (ie, value 1.0); the Turkish translation of the MTSOSD-59R had excellent known group validity. Split-half Spearman Brown corrected reliability coefficient was 0.991 for symptom occurrence and 0.992 for symptom distress. CONCLUSION: The results suggest that the Turkish scale has appropriate language, content, and construct validity. This scale can now be used to assess the symptom experience related to immunosuppressive therapy in Turkish organ transplant recipients.

Investigation of adaptation after liver transplantation using Roy's Adaptation Model.

In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients.

Quality of life in recipients before and after liver transplantation in Turkey.

CONTEXT: Liver transplantation has become the treatment of choice for patients with end-stage liver disease. Most studies show a positive effect on quality of life after liver transplantation, but most studies are based on data from Western countries and little is known about quality of life in liver transplant recipients in Turkey or other developing countries. OBJECTIVE: To investigate liver transplant recipients' quality of life and factors affecting it, before and 3 months after transplantation in western Turkey. DESIGN: Descriptive and comparative, with data collected prospectively. SETTING: Two medical centers in Western Turkey. PATIENTS: Sixty-five adult recipients of a liver transplant between May 15 and December 31,2007. INSTRUMENTS: Quality of life was measured by using the Nottingham Health Profile Turkish version, and sociodemographic and clinical data were collected from patients' records. RESULTS: Scores on all subscales of the Nottingham Health Profile differed significantly from before to after liver transplantation. The differences between the mean scores for quality of life before and after transplantation varied significantly with the patients' sex and disease severity.