Sargent Suzanne, Wainwright Steven P
Hepatology, Institute of Liver Studies, Kings College Hospital, London SE5 9RS, United Kingdom.
Intensive Crit Care Nurs. 2007 Oct;23(5):272-80. doi: 10.1016/j.iccn.2007.03.005. Epub 2007 Jul 5.
Liver transplantation is now an accepted and successful therapy for both acute and chronic liver diseases. Whilst the study of health related quality of life (HRQoL) post-transplantation for chronic liver disease (CLD) has been well documented, there is little data measuring HRQoL following liver transplantation for acute liver failure (ALF), despite super urgent transplantation constituting 16.6% of all United Kingdom liver transplantation. Therefore, the aim of the present study was to document the HRQoL in patients who have received an emergency liver transplant for ALF. Data collection employed between method triangulation, using the Short Form 36 quality of life health questionnaire for both ALF (n=47) and CLD (n=49), and six semi-structured interviews. Only the qualitative element of the study is reported here. Phenomenological analysis of the semi-structured interviews identified four themes relating to the physical changes encountered (inactivity), physical recovery (health transition); changes made to the transplant recipients life styles (modification); and outlook. The majority of transplanted ALF transplant recipients' stated that they have a good quality of life, which was often comparable to their pretransplantation lifestyle. However, the initial recovery process was often difficult and was related to the physical changes instigated from their multi-organ failure and intensive care stay, which can present numerous physical and emotional challenges.
肝移植如今已成为治疗急慢性肝病的一种公认且成功的疗法。虽然慢性肝病(CLD)患者肝移植后健康相关生活质量(HRQoL)的研究已有充分记录,但对于急性肝衰竭(ALF)患者肝移植后的HRQoL,尽管超紧急移植占英国所有肝移植的16.6%,却几乎没有相关数据。因此,本研究的目的是记录接受ALF紧急肝移植患者的HRQoL。数据收集采用方法三角测量法,对ALF患者(n = 47)和CLD患者(n = 49)均使用简短健康调查问卷36项生活质量量表,并进行了6次半结构化访谈。本文仅报告研究的定性部分。对半结构化访谈的现象学分析确定了四个主题,分别与所经历的身体变化(活动减少)、身体恢复(健康转变)、移植受者生活方式的改变(调整)以及展望有关。大多数接受ALF肝移植的受者表示他们的生活质量良好,这通常与移植前的生活方式相当。然而,最初的恢复过程往往很艰难,与多器官衰竭和重症监护住院引发的身体变化有关而这些变化可能带来诸多身体和情感上的挑战。