Patients’ Experiences of Life Challenges After Liver Transplantation: A Qualitative Study

Abstract

Patients experience a new life with different challenges after liver transplantation (LT). Identifying these challenges can facilitate the improvement of their quality of life. This study aimed to explore patients’ experiences of post-LT life challenges. This qualitative study was performed in 2019 through the content analysis approach. Participants were liver transplant recipients purposively recruited from a LT clinic. Semistructured interviews were conducted for data collection. Data were analyzed through Graneheim and Lundman’s conventional content analysis approach. Meaning units were identified and coded, and the codes were grouped into subcategories and categories according to their similarities. In total, 18 transplant recipients were interviewed. Their age mean was 51 years and their transplant age ranged from 4 months to 12 years. Their post-LT life challenges were categorized into 4 main categories, that is, self-care deficit, the need for seeking information, fears and concerns, and hope–despair duality. Nurses and members of LT team are recommended to assess transplant recipients’ life challenges and develop comprehensive plans for managing their challenges and problems and improving their quality of life.

Patient reflections, challenges, and supports related to early liver transplant for severe alcohol-associated liver disease

“…The final period (ie, life after ELT) featured the most diverse participant experiences, both positive and negative. Our analysis did not focus on the physical debilitation and recovery during the posttransplant period, as they are well represented in the literature 11,12 . Instead, we presented psychosocial accounts that seemed more particular to patients with prior unhealthy alcohol use and ELT.…”

“…Our analysis did not focus on the physical debilitation and recovery during the posttransplant period, as they are well represented in the literature. 11 , 12 Instead, we presented psychosocial accounts that seemed more particular to patients with prior unhealthy alcohol use and ELT. Central to our themes in the final period were relationships: with self, with others, and with work.…”

“…But attention has been minimal toward the ELT recipient experience: the recognition of the liver disease, transplant process, and posttransplant survivorship. Recent publications have highlighted the importance of appreciating patients’ nuanced experiences living with decompensated liver disease and after a liver transplant 9–12 . However, patients who received ELT for severe ALD are unique among liver transplant recipients in their juxtaposition of acute disease manifestation, long-standing and stigmatizing root cause, 13 and patient-reported low readiness to change harmful behaviors at transplant 14 .…”

“…Recent publications have highlighted the importance of appreciating patients' nuanced experiences living with decompensated liver disease and after a liver transplant. [9][10][11][12] However, patients who received ELT for severe ALD are unique among liver transplant recipients in their juxtaposition of acute disease manifestation, long-standing and stigmatizing root cause, [13] and patient-reported low readiness to change harmful behaviors at transplant. [14] Studies purposefully assessing ELT recipients' viewpoints are therefore crucial.…”

Factors Affecting Immunosuppressive Medication Adherence in Liver Transplant Recipients with Poor Adherence: A Qualitative Study

“…Transplant recipients consider themselves fully healed after transplantation due to regression of their primary disease-related symptoms, weakening of the side effects of immunosuppressive medication, and feeling "all right". 33,40 This phenomenon appears to be one of the patient-related factors that diminish immunosuppressive medication adherence. 4,19 In addition to patient-related factors, there are some environmental and social factors that affect adherence to immunosuppressive medication.…”