Symptoms and Distress Among Patients With Liver Cirrhosis but Without Hepatocellular Carcinoma in Taiwan

Abstract

A cross-sectional study design was used to assess the items and frequency of physical symptoms and psychological distress among patients with liver cirrhosis (LC) but without hepatocellular carcinoma. Inpatients with LC were recruited from a medical center in northern Taiwan. Informants were asked to describe their frequency of symptoms and distress at 2 weeks before admission. During August 2008 and July 2009, 49 patients participated. The symptoms and distress were moderate, with a mean of 3.9 and 4.2 of 7, respectively. The mean ranking of subscales from the highest to lowest was abdominal symptoms, fatigue, fluid retention, loss of appetite, systemic symptoms, decreased attention, and bleeding. Symptoms and distress were significantly correlated (r = .59). The total scores of symptoms and distress were not associated with causes of the disease (p = .7644, p = .8548, respectively), disease severity (p = .7203, p = .3354, respectively), disease duration (p = .5820, p = .8184, respectively), or previous admission (p = .3094, p = .7365, respectively), but decreased attention was significantly associated with disease severity (p = .0317) and systemic symptoms were significantly associated with disease duration (p = .0267). The study found that physical symptoms and psychological distress are multidimensional and highly correlated. Our findings can be used to develop a symptom management program to relieve discomfort and indirectly improve the quality of life for individuals with LC.

Nursing Diagnosis in Patients with Liver Cirrhosis in Use of Feeding Tube

“…Similar results were identified in previous studies involving critical care patients and patients in chronic conditions [25] [34]. In Taiwan, physical symptoms and psychological distress, including abdominal symptoms, fatigue, fluid retention, loss of appetite, systemic symptoms, decreased attention, and bleeding, were common among patients with liver cirrhosis [35]. These NANDA-I diagnoses require from nurses the ability and skills to identify the patients' health status in order to deliver an individualized nursing care plan focused on patient safety.…”

Patient‐reported outcomes in cirrhosis: A scoping review of the literature

“…In three cases, these were performed in focus groups with semistructured interviews. Tsai et al interviewed patients and asked them to rank‐order the most important physical and psychological components of cirrhosis . Over the course of two articles, Mikkelsen et al described the results of patient interviews focusing on the conditions that limit or support coping with physical and psychological problems before and after a group‐therapy intervention.…”

“…Of these 11 studies, four were from the United States, (6)(7)(8)(9) two from Denmark, (10,11) and one each from China, Taiwan, Japan, Spain, and Italy. (12)(13)(14)(15)(16) Overall, these studies enrolled 2,299 (range 11-544) patients. The stage of liver disease was available for 1,550 (67%), of whom 586 (38%) were Child A and 964 (62%) were Child B-C. Granular details of cirrhosis etiology were available for 1,268 (55%) patients, of whom 643 (51%) had viral hepatitis and 360 (28%) had alcoholic liver disease.…”

“…Tsai et al interviewed patients and asked them to rank-order the most important physical and psychological components of cirrhosis. (12) Over the course of two articles, (10,11) Mikkelsen et al described the results of patient interviews focusing on the conditions that limit or support coping with physical and psychological problems before and after a group-therapy intervention. Vaughn-Sandler et al mailed surveys with questions and opportunities for free-text responses to capture the rate and impact of feelings of stigma.…”

Impact of physical and psychological factors on health-related quality of life in adult patients with liver cirrhosis: a systematic review protocol

“…The physiological changes include increased portal vein pressure, impaired synthetic function, electrolyte imbalance and malnourishment 13 . These physiological changes trigger the development of physical signs and symptoms and impact muscle cramps, pruritus, fatigue, impaired mobility, breathlessness, abdominal discomfort, gastrointestinal symptoms, change of body image and pitting oedema [14][15][16][17] . Psychological symptoms include stress, depression, and anxiety 18,19 .…”