The Concept of Quality of Life in Organ Transplantation

Gastroenterology Section, Department of Surgical and Gastroenterological Sciences, Padua University, and Gastroenterology Unit, Feltre, Italy.
Transplantation Proceedings (Impact Factor: 0.98). 10/2007; 39(7):2285-7. DOI: 10.1016/j.transproceed.2007.06.013
Source: PubMed


The goal of organ transplantation is not only to ensure the survival of individuals with end-stage heart, lung, liver, kidney, pancreas, and small bowel diseases, but also to offer patients the health they enjoyed before the disease, achieving a good balance between the functional efficacy of the graft and the patient's psychological and physical integrity. Quality of life (QoL) assessments are used to evaluate the physical, psychological, and social domains of health, seen as distinct areas that are influenced by a person's experiences, beliefs, expectations, and perceptions, and QoL is emerging as a new medical indicator in transplantation medicine too.

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    • "The quality of life after the renal transplantation changes life in every single aspect. Patients after renal transplantation have to get used to the changes in the life style, they get rid of the time demanding dialyses and have more time to meet other people or they even go back to work [5]. Patients after renal transplantation improve the quality of life in short and long-term follow up [6]. "
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    ABSTRACT: The aim of the study was to define the positive effect of physical activity and nutrition on the health related quality of life in renal transplant patients in the first year following the surgery. Interestingly, the results showed that the quality of life evaluated by SF-36 of physically active renal transplant patients reached or even overreached the values of healthy individuals. We assessed the influence of intervention (physical activity, nutrition or both) on the health related quality of life. The health related quality of life was evaluated using standardized questionnaire KDQOL-SFTM (part of the generic questionnaire SF-36), and in the period one month before transplantation (patients filled the questionnaire retrospectively during their hospitalization in the first 14 days after the surgery) and approximately 10 months after the transplantation. There were 103 patients in this study (45 females, 58 males) of the age in the range 23–75 years with the average 54.7 years (±12 years). In the period when the patient was physically active or had special nutritive therapy (9.5 months after the renal transplantation) the quality of life evaluated using SF-36 (n = 94) statistically significantly improved in all domains except for physical activity (Wilcoxon test, p < 0.05) that was lower than the values of healthy individuals in the Czech Republic. The results did not show any statistically significant difference among the items of the life quality and type of intervention done (ANOVA, p < 0.05). Also the testing of the differences among particular types of intervention with regard to the evaluation of the quality of life did not show any statistically significant changes. There is a positive impact of physical activity on the quality of life of the renal transplant patients. It seems to be the most effective tool improving the quality of life, when physical activity is combined with nutrition therapy.
    12/2014; 16(4). DOI:10.1016/j.kontakt.2014.09.001
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    • "Thus, improving the quality of life (QOL) of patients with KT has become an important issue for transplantation teams (Habwe 2006). Quality of life is demonstrated through the physical, psychological and social domains of health and appears to be influenced by a person's experiences, beliefs, expectations and perceptions (Burra et al. 2007). "
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    ABSTRACT: This paper is a report of an exploration of the effects of self-efficacy and different dimensions of self-management on quality of life among kidney transplant recipients. Self-efficacy is an important factor influencing self-management. Patients with higher self-efficacy have better self-management and experience better quality of life. Self-efficacy influences the long-term medication-taking behaviour of kidney transplant recipients. A longitudinal, correlational design was used. Data were collected during 2005-2006 with 150 adult kidney transplant recipients on self-efficacy, self-management and quality of life using a self-efficacy scale, self-management scale and the Medical Outcomes Scale SF-36 (Chinese), respectively. Relationships among variables were analysed by path analysis. Participants with higher self-efficacy scored significantly higher on the problem-solving (beta = 0.51), patient-provider partnership (beta = 0.44) and self-care behaviour (beta = 0.55) dimensions of self-management. Self-efficacy directly influenced self-care behaviour and indirectly affected the mental health component of quality of life (total effect = 0.14). Problem-solving and partnership did not statistically significantly affect quality of life. Neither self-efficacy nor self-management had any effect on the physical health component of quality of life. Transplant care teams should incorporate strategies that enhance self-efficacy, as proposed by social cognitive theory, into their care programmes for kidney transplant recipients. Interventions to maintain and improve patients' self-care behaviour should continue to be emphasized and facilitated. Support to enhance patients' problem-solving skills and the partnership of patients with health professionals is needed.
    Journal of Advanced Nursing 04/2010; 66(4):828-38. DOI:10.1111/j.1365-2648.2009.05243.x · 1.74 Impact Factor
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    ABSTRACT: The meaning of quality of life has evolved to become a multidimensional and integrative concept that includes both objective and subjective criteria. Simultaneous pancreas-kidney transplantation aims not only to increase survival but also to improve health-related quality of life. Studies of health-related quality of life in simultaneous pancreas-kidney transplantations show that the improvement achieved in some dimensions can surpass values in the general population, but without reaching overall levels of health-related quality of life in this population. Qualitative studies and those analyzing psychological variables show that many patients have anxiety or identity disorders. Simultaneous pancreas-kidney transplant recipients fear graft loss, and the transplant represents not just physical but also imaginary and symbolic implantation of the other person's organs. Health-related quality of life assessments show that age, gender, years since diabetes onset, time under renal replacement therapy, and time since simultaneous pancreas-kidney transplantation have significant effects. Future studies should perform temporal evaluations to determine the variations produced after simultaneous pancreas-kidney transplantation and combine quantitative and qualitative methods to provide more exhaustive information on this topic.
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