Hochheimer Martin, Moreland Melissa L, Tuten Michelle, LaMattina John, Connelly Mark, Sacco Paul
School of Social Work, University of Maryland, Baltimore, MD.
School of Medicine, University of Maryland, Baltimore, MD.
Transplant Direct. 2019 Nov 15;5(12):e506. doi: 10.1097/TXD.0000000000000951. eCollection 2019 Dec.
Alcoholic liver disease (ALD) due to alcohol use disorder (AUD) is the primary cause of liver transplantation (LT) in the United States. Studies have found that LT recipients experience a range of physical and emotional difficulties posttransplantation including return to alcohol use, depression, and anxiety. The aim of this study is to better understand the experiences of LT recipients with ALD because they recovered posttransplant to inform the development of a patient-centered intervention to assist patients during recovery.
Using qualitative methods, researchers conducted semi-structured interviews with 16 ALD LT recipients. The primary topics of the interview were physical recovery, mental health, substance use including alcohol and tobacco use, and financial experiences. Common patient themes were identified and coded.
Within the domain of physical health, patients stressed that undergoing LT was a near-death experience, they were helpless, changes in weight influenced their perception of their illness, and they have ongoing medical problems. In the domain of mental health, patients described cognitive impairments during their initial recovery, difficulty in processing the emotions of having a terminal condition, ongoing depression, anxiety, and irritability. The patients also described their perception of having AUD, the last time they used alcohol and their attitude to AUD treatment posttransplant. Patients also described their reliance on one member of their social support network for practical assistance during their recovery and identified one member of their medical team as being of particular importance in providing emotional as well as medical support during recovery.
The patient's description of their lived experience during the months following transplant informed the development of a patient-centered intervention that colocates behavioral health components with medical treatment that helps broaden their social network while addressing topics that emerged from this study.
酒精使用障碍（AUD）所致的酒精性肝病（ALD）是美国肝移植（LT）的主要原因。研究发现，肝移植受者在移植后会经历一系列身体和情绪上的困难，包括重新饮酒、抑郁和焦虑。本研究的目的是更好地了解酒精性肝病肝移植受者移植后康复的经历，以为制定以患者为中心的干预措施提供参考，在康复过程中帮助患者。
研究人员采用定性方法，对16名酒精性肝病肝移植受者进行了半结构化访谈。访谈的主要主题包括身体康复、心理健康、物质使用（包括酒精和烟草使用）以及财务经历。确定并编码了常见的患者主题。
在身体健康方面，患者强调接受肝移植是一次濒死经历，他们感到无助，体重变化影响了他们对疾病的认知，并且他们存在持续的医疗问题。在心理健康方面，患者描述了最初康复期间的认知障碍，难以处理患有绝症的情绪，持续存在抑郁、焦虑和易怒情绪。患者还描述了他们对酒精使用障碍的认知、最后一次饮酒时间以及移植后对酒精使用障碍治疗的态度。患者还描述了在康复过程中对社会支持网络中一名成员提供实际帮助的依赖，并指出医疗团队中的一名成员在康复期间提供情感和医疗支持方面尤为重要。
患者对移植后数月生活经历的描述为制定以患者为中心的干预措施提供了参考，该干预措施将行为健康成分与医疗治疗相结合，有助于扩大他们的社交网络，同时解决本研究中出现的问题。
