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Original Article

Factors Influencing the Quality of Life in Families of Patients with Liver Transplantation

So Young Kim1, Yun Mi Lee2
Korean Journal of Adult Nursing 2016;28(3):279-287.
Published online: June 30, 2016

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Corresponding author: Lee, Yun Mi Department of Nursing, College of Medicine, Inje University, 75 Bokji-ro, Pusanjin-gu, Busan 614-735, Korea. Tel: +82-51-890-6933, Fax: +82-51-896-9840, E-mail: lym312@inje.ac.kr
• Received: March 16, 2016   • Accepted: June 22, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify factors influencing a family's quality of life (QoL) when one member has a liver transplantation.
  • Methods
    A total of 98 families were asked questions about characteristics, stress, social support and QoL. The instruments used for this study were the Stress Scale for Families of Liver Transplantation Recipients, the Personal Resources Questionnaire, the Korean version of QoL Simple Type Scale. Data were analyzed by t-test, ANOVA, Pearson's correlation coefficient and multiple regression.
  • Results
    The mean scores of stress was 2.58±0.75 and of social support was 4.81±0.87. The mean of the QoL was 3.39±0.60. Quality of life had significant correlations with stress and social support. Using multiple regression analysis, the QoL was significantly influenced by social support, stress and monthly average household income.
  • Conclusion
    The results suggest that social support, stress and income should be considered in developing the nursing interventions to improve the QoL of families of patients with liver transplantation.
  • Key Words: Liver transplantation; Family; Stress; Social support; Quality of life
Table 1.
General Characteristics of Families of Liver Transplantation Patients (N=98)
Variables Categories n (%) or M±SD
Age (year)   49.64±11.31
20~29 7 (7.1)
30~39 9 (9.2)
40~49 28 (28.6)
50~59 35 (35.7)
≥60 19 (19.4)
Gender Male 29 (29.6)
Female 69 (70.4)
Relationship to the patient Spouse 67 (68.4)
Children 22 (22.4)
Parents 5 (5.1)
Brothers and sisters 4 (4.1)
Level of education Elementary school 8 (8.2)
Junior high school 9 (9.2)
High school 41 (41.8)
College 12 (12.1)
University 28 (28.6)
Marital status Unmarried 13 (13.3)
Married 85 (86.7)
Religion No 25 (25.5)
Buddhism 55 (56.1)
Christianity 12 (12.2)
Catholic 6 (6.1)
Occupation Business owners 17 (17.3)
Employee 23 (23.5)
Office work 4 (4.1)
Student 4 (4.1)
No 43 (43.9)
Other 7 (7.1)
Monthly household income (10,000 won) ≤100 12 (12.2)
101~200 22 (22.4)
201~300 25 (25.5)
301~400 22 (22.4)
≥401 17 (17.3)
Treatment burden Patient 32 (32.7)
Spouse 23 (23.5)
Children 9 (9.2)
Joint family burdens 30 (30.6)
None (other) 4 (4.1)
Years taken care of the patient ＜1 41 (41.8)
1~3 41 (41.8)
3~5 13 (13.3)
＞5 4 (4.1)
Co-residence Living together 84 (85.7)
Living separately 14 (14.3)
Type of liver transplantation surgery Deceased donor 51 (52.0)
Living donor 47 (48.0)
Presence of disease Yes 25 (25.5)
No 73 (74.5)
Table 2.
Scores for Stress, Social Support and Quality of Life (N=98)
Variables M±SD Min~Max Range
Stress 2.58±0.75 1.11~4.34 1~5
 Psychosocial stress 2.93±0.96 1.00~4.76  
 Family relationship 2.07±0.77 1.00~4.00  
 Economic burden 2.62±0.98 1.00~4.67  
Social support 4.81±0.87 2.10~6.80 1~7
 Worth and confidence 4.90±0.83 2.80~7.00  
 Intimacy and affection 4.90±1.04 1.60~7.00  
 Acquisition of guidance 4.69±1.02 1.00~7.00  
 Social integration 4.75±0.93 1.80~6.80  
Quality of life 3.39±0.60 1.81~4.81 1~5
 Physical health 3.52±0.62 2.29~5.00  
 Psychological health 3.32±0.69 1.17~5.00  
 Social relations 3.16±0.72 1.00~5.00  
 Environment 3.45±0.73 1.38~5.00  
 General health status 3.29±1.04 1.00~5.00  
 General quality of life 3.2±30.89 1.00~5.00  
Table 3.
Difference in Quality of Life according to Family's Characteristics (N=98)
Characteristics Categories Quality of life
M±SD t or F (p)
Age (year) 20~29 3.89±0.64 1.86
30~39 3.54±0.50 (.122)
40~49 3.27±0.59
50~59 3.42±0.59
≥60 3.28±0.60
Gender Male 3.52±0.54 1.37
Female 3.34±0.62 (.171)
Relationship to the patient Spouse 3.36±0.59 1.40
Children 3.59±0.57 (.246)
Parents 3.13±0.52
Brothers and sisters 3.18±0.88
Level of education Elementary school 3.50±0.54 0.96
Junior high school 3.12±0.62 (.432)
High school 3.39±0.66
College 3.25±0.44
University 3.51±0.57
Marital status Unmarried 3.65±0.55 1.69
Married 3.35±0.60 (.093)
Religion No 3.40±0.59 2.01
Buddhism 3.37±0.52 (.117)
Christianity 3.68±0.66  
Catholic 2.96±0.98  
Occupation Yes 3.45±0.59 1.11
No 3.32±0.61 (.269)
Years taken care of the patient ＜1 3.24±0.59 1.82
1~3 3.48±0.61 (.148)
3~5 3.62±0.50  
＞5 3.26±0.60  
Monthly household income (10,000 won) ≤200 3.23±0.63 -3.68
≥201 3.64±0.46 (.001)
Treatment burden Patient 3.50±0.50 1.04
Spouse 3.42±0.58 (.388)
Children 3.40±0.79
Joint family burdens 3.22±0.67
None (other) 3.66±0.30
Co-residence Living together 3.41±0.60 0.69
Living separately 3.29±0.60 (.490)
Type of liver transplantatio n surgery Deceased donor 3.28±0.61 -1.93
Living donor 3.51±0.56 (.056)
Presence of disease Yes 3.06±0.60 -3.31
No 3.51±0.56 (.001)
Table 4.
Correlation among Stress, Social Support and Quality of Life (N=98)
Variables Stress Social support Quality of life
r (p) r (p) r (p)
Stress 1    
Social support -.59 (＜.001) 1  
Quality of life -.68 (＜.001) .80 (＜.001) 1
Table 5.
Factors influencing the Quality of Life in Families of Liver Transplantation Patients (N=98)
Variables B SE β t p
(Constant) 51.06 8.51   5.99 ＜.001
Social support 0.51 0.06 .57 8.51 ＜.001
Stress -0.17 0.04 -.29 -4.37 ＜.001
Average monthly household income† 4.81 1.75 .15 2.75 .007
Presence of disease† 2.36 2.04 .06 1.16 .249
  Adj R2=.72, F=66.25, p＜.001

†Dummy variable; Average monthly income:≤200million won=0,≥201million won=1; Presence of disease: No=0, Yes=1 .

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    Factors Influencing the Quality of Life in Families of Patients with Liver Transplantation
    Korean J Adult Nurs. 2016;28(3):279-287.   Published online June 30, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.3.279
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    Factors Influencing the Quality of Life in Families of Patients with Liver Transplantation
    Korean J Adult Nurs. 2016;28(3):279-287.   Published online June 30, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.3.279
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    Factors Influencing the Quality of Life in Families of Patients with Liver Transplantation
    Factors Influencing the Quality of Life in Families of Patients with Liver Transplantation

    General Characteristics of Families of Liver Transplantation Patients (N=98)

    Variables Categories n (%) or M±SD
    Age (year)   49.64±11.31
    20~29 7 (7.1)
    30~39 9 (9.2)
    40~49 28 (28.6)
    50~59 35 (35.7)
    ≥60 19 (19.4)
    Gender Male 29 (29.6)
    Female 69 (70.4)
    Relationship to the patient Spouse 67 (68.4)
    Children 22 (22.4)
    Parents 5 (5.1)
    Brothers and sisters 4 (4.1)
    Level of education Elementary school 8 (8.2)
    Junior high school 9 (9.2)
    High school 41 (41.8)
    College 12 (12.1)
    University 28 (28.6)
    Marital status Unmarried 13 (13.3)
    Married 85 (86.7)
    Religion No 25 (25.5)
    Buddhism 55 (56.1)
    Christianity 12 (12.2)
    Catholic 6 (6.1)
    Occupation Business owners 17 (17.3)
    Employee 23 (23.5)
    Office work 4 (4.1)
    Student 4 (4.1)
    No 43 (43.9)
    Other 7 (7.1)
    Monthly household income (10,000 won) ≤100 12 (12.2)
    101~200 22 (22.4)
    201~300 25 (25.5)
    301~400 22 (22.4)
    ≥401 17 (17.3)
    Treatment burden Patient 32 (32.7)
    Spouse 23 (23.5)
    Children 9 (9.2)
    Joint family burdens 30 (30.6)
    None (other) 4 (4.1)
    Years taken care of the patient ＜1 41 (41.8)
    1~3 41 (41.8)
    3~5 13 (13.3)
    ＞5 4 (4.1)
    Co-residence Living together 84 (85.7)
    Living separately 14 (14.3)
    Type of liver transplantation surgery Deceased donor 51 (52.0)
    Living donor 47 (48.0)
    Presence of disease Yes 25 (25.5)
    No 73 (74.5)

    Scores for Stress, Social Support and Quality of Life (N=98)

    Variables M±SD Min~Max Range
    Stress 2.58±0.75 1.11~4.34 1~5
     Psychosocial stress 2.93±0.96 1.00~4.76  
     Family relationship 2.07±0.77 1.00~4.00  
     Economic burden 2.62±0.98 1.00~4.67  
    Social support 4.81±0.87 2.10~6.80 1~7
     Worth and confidence 4.90±0.83 2.80~7.00  
     Intimacy and affection 4.90±1.04 1.60~7.00  
     Acquisition of guidance 4.69±1.02 1.00~7.00  
     Social integration 4.75±0.93 1.80~6.80  
    Quality of life 3.39±0.60 1.81~4.81 1~5
     Physical health 3.52±0.62 2.29~5.00  
     Psychological health 3.32±0.69 1.17~5.00  
     Social relations 3.16±0.72 1.00~5.00  
     Environment 3.45±0.73 1.38~5.00  
     General health status 3.29±1.04 1.00~5.00  
     General quality of life 3.2±30.89 1.00~5.00  

    Difference in Quality of Life according to Family's Characteristics (N=98)

    Characteristics Categories Quality of life
    M±SD t or F (p)
    Age (year) 20~29 3.89±0.64 1.86
    30~39 3.54±0.50 (.122)
    40~49 3.27±0.59
    50~59 3.42±0.59
    ≥60 3.28±0.60
    Gender Male 3.52±0.54 1.37
    Female 3.34±0.62 (.171)
    Relationship to the patient Spouse 3.36±0.59 1.40
    Children 3.59±0.57 (.246)
    Parents 3.13±0.52
    Brothers and sisters 3.18±0.88
    Level of education Elementary school 3.50±0.54 0.96
    Junior high school 3.12±0.62 (.432)
    High school 3.39±0.66
    College 3.25±0.44
    University 3.51±0.57
    Marital status Unmarried 3.65±0.55 1.69
    Married 3.35±0.60 (.093)
    Religion No 3.40±0.59 2.01
    Buddhism 3.37±0.52 (.117)
    Christianity 3.68±0.66  
    Catholic 2.96±0.98  
    Occupation Yes 3.45±0.59 1.11
    No 3.32±0.61 (.269)
    Years taken care of the patient ＜1 3.24±0.59 1.82
    1~3 3.48±0.61 (.148)
    3~5 3.62±0.50  
    ＞5 3.26±0.60  
    Monthly household income (10,000 won) ≤200 3.23±0.63 -3.68
    ≥201 3.64±0.46 (.001)
    Treatment burden Patient 3.50±0.50 1.04
    Spouse 3.42±0.58 (.388)
    Children 3.40±0.79
    Joint family burdens 3.22±0.67
    None (other) 3.66±0.30
    Co-residence Living together 3.41±0.60 0.69
    Living separately 3.29±0.60 (.490)
    Type of liver transplantatio n surgery Deceased donor 3.28±0.61 -1.93
    Living donor 3.51±0.56 (.056)
    Presence of disease Yes 3.06±0.60 -3.31
    No 3.51±0.56 (.001)

    Correlation among Stress, Social Support and Quality of Life (N=98)

    Variables Stress Social support Quality of life
    r (p) r (p) r (p)
    Stress 1    
    Social support -.59 (＜.001) 1  
    Quality of life -.68 (＜.001) .80 (＜.001) 1

    Factors influencing the Quality of Life in Families of Liver Transplantation Patients (N=98)

    Variables B SE β t p
    (Constant) 51.06 8.51   5.99 ＜.001
    Social support 0.51 0.06 .57 8.51 ＜.001
    Stress -0.17 0.04 -.29 -4.37 ＜.001
    Average monthly household income† 4.81 1.75 .15 2.75 .007
    Presence of disease† 2.36 2.04 .06 1.16 .249
      Adj R2=.72, F=66.25, p＜.001

    †Dummy variable; Average monthly income:≤200million won=0,≥201million won=1; Presence of disease: No=0, Yes=1 .
    Table 1. General Characteristics of Families of Liver Transplantation Patients (N=98)

    Table 2. Scores for Stress, Social Support and Quality of Life (N=98)

    Table 3. Difference in Quality of Life according to Family's Characteristics (N=98)

    Table 4. Correlation among Stress, Social Support and Quality of Life (N=98)

    Table 5. Factors influencing the Quality of Life in Families of Liver Transplantation Patients (N=98)

    Dummy variable; Average monthly income:≤200million won=0,≥201million won=1; Presence of disease: No=0, Yes=1 .

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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