Quality of life, self-transcendence, illness distress, and fatigue in liver transplant recipients

Wright, Kathy Baker
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This cross sectional study described the relationship between quality of life (QOL) and self-transcendence (ST) in liver transplant recipients. Self-transcendence is a dynamic process reflecting spiritual growth and maturity and a broadening of personal perspective during challenging life experiences. Illness distress, fatigue, age, gender, marital status, education, and time-since-transplant were also investigated relative to QOL. Participants (n = 471) were primarily Caucasian (86.5%), male (53.5%), married (73.5%), religiously affiliated (93.4%), and perceived their health status as "good" (48%) or "excellent" (19%). Participants with the highest ST scores (M = 3.36, S.D. = .37, possible range 1-4) were female, older (65-79 years), or recently transplanted (< 2 years). Females reported significantly higher ST scores than males. Participants with the highest QOL scores (M = 23.73, S.D. = 4.88, possible range = 0-30) were female, older (65-79 years), and transplanted 3-5 years ago. Strong relationships existed between QOL and ST scores (r = .51, p < .01), illness distress and fatigue scores (r = .51, p < .01), and QOL and illness distress scores (r = -.71, p < .01). Moderate relationships existed between QOL and fatigue scores (r = -.45, p < .01) and ST and illness distress scores (r = -.36, p < .01). Self-transcendence and fatigue scale scores had a weak relationship (r = -.20, p < .01). Illness distress scores were low (M = 15.30; SD = 13.47, possible range 0-88) as were fatigue scores (M = 4.23; SD = 2.04, possible range 1-10). Regression analysis revealed illness distress, ST, fatigue, and age accounted for 60% of the variance in QOL scores. Most respondents reported post-transplant QOL as better than expected. Comorbidities had a major impact on post-transplant QOL. Financial resources were adequate. Multiple factors were cited as important to QOL including family, friends, health, spirituality, productivity, happiness, and job security. This study suggests self-rated QOL and ST are high for liver transplant recipients while illness distress and fatigue are low. Females have significantly higher ST scores than males. Self-transcendence, illness distress, fatigue, and age are important factors related to QOL and should be further investigated.