Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation

Abstract

BACKGROUND Depression, anxiety, and altered self-care ability are among the most important factors affecting the quality of life of liver transplant recipients. Depending on the severity of the underlying liver disease, signs and symptoms of anxiety and depression may become more pronounced. AIM To evaluate the factors affecting depression, anxiety and self-care abilities of liver transplant recipients. METHODS Recipients who are ≥ 18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional study. Sample size analysis showed that the minimum number of recipients should be 301 (confidence level = 95%, confidence interval = 2.5, population = 1382). Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were analyzed. The dependent variables were the Beck Depression Scale, State-Trait Anxiety Scale (Form I and II), and Self-Care Agency Scale. The independent variables of the study were sociodemographic characteristics, biliary complications, hepatocellular carcinoma, recommending liver transplantation to other patients, and the interval of out-patient clinic visits. RESULTS Self-care ability scores were lower ( P = 0.002) and anxiety scores were higher ( P = 0.004) in recipients with biliary complications. On the other hand, in recipients with hepatocellular carcinoma, self-care scores were lower ( P = 0.006) while depression ( P = 0.003) and anxiety scores ( P = 0.009) were higher. Liver transplantation recipients with a monthly income < 3000 Turkish liras had higher depression ( P < 0.001) and anxiety ( P = 0.003) scores. The recipients who stated that they would not recommend liver transplantation to others had lower self-care scores ( P = 0.002), higher depression ( P < 0.001), higher state anxiety ( P = 0.02), and trait anxiety ( P < 0.001) scores. CONCLUSION Presence of biliary complications and hepatocellular carcinoma, low income level, and an obligation for monthly visits to the outpatient clinic are factors that are found to affect self-care capability, depression, and anxiety.

Effect of the COVID-19 Pandemic on the Psychological Health of Patients Who Underwent Liver Transplantation Due to Hepatocellular Carcinoma

“…For these reasons, reduced postoperative quality of life and psychosocial disorders may be higher, especially in patients. Furthermore, the presence of HCC as an indication of LT has an additional impact on the patients’ psychosocial well-being and quality of life [ 41 ]. In addition, patients with impaired quality of life in the pre-LT period (such as advanced end-stage liver disease and complications of cirrhosis that deteriorate the physiologic condition of the patient) have also deteriorated the health-related quality of life in the post-LT period.…”

Prevalence and Risk Factors of Anxiety Among Adult Patients with Chronic Pharyngitis in Wuhu, China

“…However, there was no statistical significance in anxiety of patients with CP with different monthly income. It has been reported that monthly income was shown to have significant impacts on anxiety symptoms among stroke patients, 27 patients with liver transplantation, 28 and dialysis patients. 29 It is unclear why monthly income of patients with CP had no impact on anxiety symptoms in the present study.…”

Depression in transplantation

“…Studies have confirmed some of the known risk factors for depression in transplantation: low income [42], female gender, younger age [35] and unemployment [19]. Laboratory values associated with increased risk of depression in kidney recipients were parathyroid hormone level, ferritin levels [43] and triglyceride levels [25].…”

“…Laboratory values associated with increased risk of depression in kidney recipients were parathyroid hormone level, ferritin levels [43] and triglyceride levels [25]. Other medical factors associated with depression include biliary complications and hepatocellular carcinoma for liver transplant recipients [42], New York Heart Associations class II, III/IV and steroid treatment for heart recipients [41], fat mass and anthropometric parameters of obesity for kidney recipients [25]. In liver transplant candidates, there were no differences in depression between patients with low MELD score (<15) and those with high MELD score (>15) [44].…”