Background/Aims With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment.
Methods Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL.
Results A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue and weakness were the most frequent symptoms.
Conclusions The data shows that as many as 50% of total patients returned to work after receiving LT. Fatigue and weakness were the most common complaints of the unemployed group, and resolving the causes of these symptoms may help to increase the employment rate.
Citations
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만성 C형 간염 환자에 있어 건강관련성 삶의 질(HRQOL)의 감소에 대한 연구가 보고되고 있으며 이런 HRQOL의 감소는 간질환의 중증도와 관련이 없다고 알려져 있는데 이런 현상의 원인으로 예민도가 떨어지는 HRQOL 도구의 사용이나 간 외 요소의 영향의 규명이 불충분한데 기인한다. 본 연구에서는 만성 C형 간염(CHC) 환자에서 약물 중독의 과거력이나 현재의 다른 내과적 질병이나 정신적 질환 등 간 외 질환의 동반여부가 HRQOL score에 영향을 줄 수 있다는 가정에서 시작되었다.
본 연구에서는 기존의 인터페론 치료에 실패했던 107명의 환자를 대상으로 HRQOL을 객관적으로 측정할 수 있는 지표로 질병의 특성에 따른 modified short form (SF-36)과 일반적 건강 척도인 Health Utilities Index (HUI) Mark II/III를 이용하여 HRQOL score에 영향을 줄 수 있는 변수를 조사하였다. sALT, HCV RNA level, HCV genotype, liver histology 등과 같은 간질환의 지표와 인구 통계학적 변수는 HRQOL에 관련이 없었으며, 또한 음주나 정맥주사 약물 남용 및 의존성도 HRQOL score과는 유의한 상관관계가 없었다. 그러나 한가지 혹은 그 이상의 내과질환이 동반되거나, 특히 통증을 동반하는 질환과 치료가 필요한 우울증 같은 정신과적 질환이 modified SF-36과 HUI score에 영향을 주는 것으로 나타났다(p<0.001).
Chang Keun Park, M.D., Soo Young Park, M.D., Eun Soo Kim, M.D., Jin Hyung Park, M.D.,
Dong Woo Hyun, M.D., Young Mi Yun, M.D., Chang Min Jo, M.D., Won Young Tak, M.D.,
Young Oh Kweon, M.D., Sung Kook Kim, M.D., Yong Hwan Choi, M.D. and Shin Goo Park, M.D.1
Background/Aims The aim of this study was to measure health related quality of life (HRQOL) in patients with chronic viral hepatitis or cirrhosis and to determine factors associated with more severe impairment. Methods: We conducted a cross-sectional study in which we documented patients` demographic and clinical characteristics and measured their HRQOL using the Korean version of Short form-36. A total of 375 patients were enrolled in the study. We compared patients` HRQOL with that of 750 participants in a control group and assessed the association of HRQOL impairment with clinical parameters. Results: In all except two domains (physical functioning, bodily pain) of SF-36, HRQOL scores were significantly lower in the patient group than in the control group (p<0.001). The difference was more prominent in those domains reflective of mental, rather than physical, health. When patient group was classified as noncirrhosis, child A, B, or C according to modified Child-Pugh classification, severe liver disease was associated with a lower HRQOL score. Interestingly, scores of domains reflective of mental health were decreased from the early stage of disease (noncirrhosis or Child-Pugh A). Those of domains reflective of physical health, however, were decreased only in advanced stages of disease (Child-Pugh B or C). There are weak but significant correlations between SF-36 scores and age, serum albumin, serum bilirubin, and prothrombin time, but no correlation with histologic activity, transaminase level, disease duration, virus type (HBV or HCV) and HBV DNA level. Conclusions: Compared with the control group, patients with chronic viral hepatitis or cirrhosis showed substantial impairment of HRQOL, which is further affected by worsening disease severity. More concern about HRQOL should be warranted in the evaluation of health change due to disease progression or therapeutic trial.(Korean J Hepatol 2003;9:212-221)
Sehyun Kim, Ph.D.1, Ki Hyun Choi, M.D.2, Seong Gyu Hwang, M.D.2, Ji Hyun Lee, M.D.2,
Sun Young Kwak, M.D.2, Pil Won Park, M.D.2, Yukyung Kim, M.D.2,
Hye Ja Park, Ph.D.3, Soon Joo Kim, M.A.4, Kyu Sung Rim2, M.D.
Background/Aims Assessment of Health-related quality of life (HRQOL) outcomes in treatment of chronic
disease is increasingly important. The objective of this study was to validate a Korean translation of the Liver
Disease Quality of Life instrument (LDQOL version 1.0) for use in patients with chronic liver disease. Methods:
Two native Korean speakers with fluent English translated LDQOL including instructions, items, and response
choices. This Korean translation of the LDQOL was administered to 121 patients with chronic liver disease.
Cronbach's alpha coefficients were applied to test an internal consistency reliability of disease-specific scales
of the LDQOL. MELD and modified CTP scores were calculated for all patients. Associations of MELD and
modified CTP scores with severity of liver disease were analyzed with LDQOL. Results: Internal consistency
reliability was good (Cronbach's Alpha=0.69-0.94) in liver disease specific scales, except for the quality of
social interaction scale (Cronbach's Alpha= 0.56). Mean modified CTP score and MELD score were 6.2±1.9
and 9.3±5.3, respectively. Both MELD score and modified CTP score showed correlations with most of the
scores of liver disease specific scales of LDQOL 1.0, except for the quality of social interaction and sleep scale.
Conclusions The Korean version of the liver disease specific scales of the LDQOL 1.0 is validated and useful
for measuring HRQOL in Korean patients with chronic liver disease. (Korean J Hepatol 2007;13: 44-50)
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