Symptoms And Function During The Early Recovery Period Following Orthotopic Liver Transplantation Surgery
Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: Background: Following OLT surgery, studies have focused more on long-term patient-reported outcomes, and less on those amenable to earlier intervention. The few early recovery period studies documented pain, mood changes, fatigue and functional limitations, but did not explore fully the relationships between these symptoms and function. This study examined the relationships of pain, mood, fatigue and fatigue impact and function in the early postoperative period, and explored the relationship between patients’ function and the fatigue and fatigue impact of primary caregivers. Method: A prospective, descriptive correlational repeated-measures design was used to collect data at baseline postoperatively, then at 4, 8 and 12 weeks upon discharge using the Brief Pain Inventory-Short Form, Profile of Mood States-Short Form, Modified Fatigue Impact Scale and the Human Activity Profile (HAP). Data for caregiver fatigue and fatigue impact were also collected. Results: Patients (N = 58) were on average 54 (10.4) years old, mostly male (66%), married (77%) and 65% had untreatable viral, alcohol-induced or autoimmune liver disease. The 23 primary caregivers were on average 56.5(7.85) years old, female (71%) and life partners of patients (88%). Linear regression analysis found no significant association between pain, mood, fatigue and function. Fatigue impact explained 11% of the variance in the patients’ HAP adjusted activity scores (AAS; p = .11). No significant association was found between the fatigue and fatigue impact of caregivers and the function of patients. Throughout follow-up, patients reported their worst pain upon movement in the moderate range. At 12 weeks, 22% reported moderate to severe pain upon movement, 28% reported moderate to extreme fatigue levels, and 21% reported fatigue impact often or almost always. Baseline HAP-AAS scores were low, but improved throughout follow up. At 12 weeks, patients’ mean HAP-AAS scores suggested functional impairment. Caregiver fatigue and fatigue impact scores were in the moderate range at baseline, and in the mild range by 12 weeks. Conclusion: Future interventional studies are needed pre- and postoperatively, to minimize fatigue impact and evaluate the outcomes of these interventions on the postoperative function. More caregivers are also required to determine their fatigue and fatigue impact during the early recovery period, to support them during the early recovery period.
Source: TSpace (University of Toronto)
Author: Salima Ladak
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2567642203