Development and Psychometric Testing of Liver Transplant Therapeutic Adherence Questionnaire in a Triphasic Mixed-Method Study

Introduction: Due to the high nonadherence rate to posttransplant regimen and medical indications among liver transplant recipients, systematic patient-centered interventions are needed to improve the medium- and long-term graft and patient survival outcomes. Objective: The aim of this study was to develop and test the psychometric properties of Liver Transplant Therapeutic Adherence Questionnaire. Design: A mixed-method instrument design was conducted in 3 phases: (1) initial item collection was generated by inductive content analysis on internationally available resources, (2) item screening was carried out by a 3-member committee and 25 domain experts including nurses and physicians aiming to establish content validity, and (3) data were collected from 247 liver transplant recipients in May 2016 for psychometric testing. Results: A total of 221 knowledge statements were extracted as potential adherence assessment items. The qualitative screening phase resulted in top 35 important items. The second screening phase was performed quantitatively by 25 experts (n = 14 nurses, n = 7 gastroenterologists and hepatologists, and n = 4 transplant surgeons). A total of 16 items were associated with statistically significant content validity ratio values (≥0.37) to be included in the final questionnaire. Exploratory factor analysis revealed a distinct 4-factor structure that was labeled as: daily activities (α = .93), immunization (α = .93), nutrition (α = .92), and major complications (α = .79). Discussion: Our results reveal evidence of acceptable reliability and validity for Liver Transplant Therapeutic Adherence Questionnaire. This instrument makes it possible to measure recipients’ therapeutic adherence in both domains of research and practice.

Download Full-text

Quality of Life in Liver Transplant Recipients: A Retrospective Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17113809 ◽

2020 ◽

Vol 17 (11) ◽

pp. 3809

Author(s):

Rosario Girgenti ◽

Alessandro Tropea ◽

Maria Antonina Buttafarro ◽

Rosalia Ragusa ◽

Martina Ammirata

Keyword(s):

Quality Of Life ◽

Liver Transplantation ◽

Liver Transplant ◽

Deceased Donor ◽

Transplant Recipients ◽

Therapeutic Adherence ◽

The Individual ◽

End Stage ◽

Liver Transplant Recipients

Background: This study aims to investigate the quality of life and the therapeutic compliance of the patients who received a liver transplant, from a living or deceased donor, at IRCCS ISMETT in the last three years. Liver transplantation is an effective therapeutic strategy for patients with end-stage liver failure. The quality of life (QOL) of liver disease patients is placed under considerable stress due to the debilitating clinical conditions and related issues experienced in everyday life by these individuals. The concept of QOL is being increasingly used to define the individual perception of health, including physical, mental, and social wellbeing. The success of a liver transplant should therefore be intended not only in terms of survival, but also of recovery of a satisfying quality of life. For this reason, our liver transplant recipients are closely monitored and supported from a psychological standpoint. This is done to monitor their ability to adapt to and comply with their clinical condition and to verify their gradual resumption of their path of life Methods: We retrospectively analyzed data collected by the IRCCS ISMETT Clinical Psychology Service during routine psychological follow-up of liver transplant recipients. Data refer to 82 patients who received a liver transplant between January 2017 and September 2019 and describe their QOL and therapeutic adherence. The obtained results were compared with the main studies on this issue available in literature. Results: Ninety-four percent of liver transplant recipients reported high mean scores of quality of life and therapeutic adherence 28% of patients reported at least one persistent annoying symptom after transplantation, although in some cases this did not affect the overall QOL. The results also refer to patients with a pre-transplant diagnosis of alcohol-related cirrhosis, who confirm their complete abstinence from alcohol. Conclusions: Our results confirm the efficacy of the liver transplantation to achieve of a good QOL. Furthermore, these patients seem to maintain high therapeutic adherence, thus ensuring a good outcome of the care received during the transplantation process.

Download Full-text