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Original Article

Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B

Ja-Ok Kim1, Man Woo Kim2, Ja-Sook Kim3, Su-Jeong Han4, Sehyun Kim5
Korean Journal of Adult Nursing 2014;26(3):287-299.
Published online: June 30, 2014

1Department of Nursing, Wonkwang Health Science University, Iksan

2Department of Internal Medicine, Chosun University Hospital ․ College of Medicine, Chosun University, Gwangju

3Department of Nursing, Dongkang College, Gwangju

4Department of Nursing, Konyang University, Daejeon

5Graduate School, Department of Medical Consilience, Dankook University, Yongin, Korea

Corresponding author: Han, Su Jeong Department of Nursing, Konyang University, 158 Kwanjeodong-ro, Seo-gu, Daejon 302-832, Korea. Tel: +82-42-600-6344, Fax: +82-42-600-6314, E-mail: sjhan@konyang.ac.kr
• Received: February 10, 2014   • Accepted: April 24, 2014

Copyright © 2014 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 aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB).
  • Methods
    A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0.
  • Results
    Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL (R2=.03~.22, p=.041~<.001).
  • Conclusion
    CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.
  • Key Words: Health-related quality of life; Chronic Hepatitis B
Table 1.
General Characteristics, Health Behavior and Clinical Characteristics of Participants (N=114
Characteristics Categories n (%) or M±SD
Age (year) ＜40 34 (29.8)
≥40 80 (70.2)
46.19±12.85
Gender Male 94 (82.5)
Female 20 (17.5)
Spouse Yes 83 (72.8)
No 31 (27.2)
Education level Below high school 54 (47.4)
Above college 60 (52.6)
Religion Yes 62 (54.4)
No 52 (45.6)
Care provider Non-medical personnel 91 (79.8)
Medical personnel 23 (20.2)
Occupation Yes 79 (69.3)
No 35 (30.7)
Monthly income (10,000 won) ＜100 31 (27.2)
100~199 34 (29.8)
200~299 20 (17.6)
≥300 29 (25.4)
Alcohol drinking Yes 19 (16.7)
No 95 (83.3)
Smoking Yes 24 (21.1)
No 90 (78.9)
Concomitant disease Yes 54 (47.4)
No 60 (52.6)
Aggravation of disease Serious (≥5 times ALT) 4 (3.5)
Moderate (2~＜5 times ALT) 7 (6.1)
Stable (＜2 times ALT) 103 (90.4)
Drug resistance mutation Yes 57 (50.0)
No 57 (50.0)
Medication duration (year) ＜1 24 (21.0)
1~＜3 28 (24.6)
3~＜5 36 (31.6)
≥5 26 (22.8)
Serum liver function test (normal range)    
  AST (7~40 U/L)   47.93±100.29
  ALT (5~57 U/L)   49.67±74.73
  Albumin (3.5~5.5 g/dL)   4.51±0.52
  Bilirubin (0.2~1.0 mg/dL)   2.98±16.98
  ALP (38~126 U/L)   64.11±25.32
  GGT (Male: 3~39 U/L, Female: 1~27 U/L)   63.45±93.96

AST=aspartate transaminase; ALT=alanine transaminase; ALP=alkaline phosphatase; GGT=gamma glutamyl transpeptidase.

Table 2.
SF-36 and Liver Disease Targeted Scales of LDQOL 1.0 (N=114)
Variables M±SD Range
SF-36 Physical functioning 71.75±19.00 0~85.00
Role limitation-physical 78.62±27.32 0~100.00
Bodily pain 60.70±16.97 0~70.00
General health 50.18±20.32 0~95.00
Vitality 53.67±21.87 0~93.75
Social functioning 70.83±22.54 0~87.50
Role limitation-emotion 57.94±20.80 0~100.00
Mental health 65.22±17.60 0~85.00
Liver Disease Targeted Scales of LDQOL Symptoms of liver disease 87.54±14.58 29.41~100.00
Effects of liver disease 82.67±12.45 32.76~100.00
Concentration 93.11±12.38 34.29~100.00
Memory 91.35±13.70 30.00~100.00
Quality of social interaction 80.67±12.19 36.00~100.00
Health distress 53.71±12.24 13.33~66.67
Sexual functioning 80.90±16.44 20.00~100.00
Sexual problems (n=76) 87.61±16.19 41.67~100.00
Sleep 70.77±16.26 24.00~100.00
Loneliness 85.47±15.35 20.00~100.00
Hopelessness 71.97±18.90 30.00~100.00
Stigma of liver disease 83.27±18.71 20.00~100.00

LDQOL=liver disease quality of life.

Table 3.
SF-36 according to General Characteristics and Clinical Characteristics (N=114)
Characteristics Categories n (%) SF-36
PF RP BP GH VT SF RE MH
M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD
Age (year) ＜40 34 (29.8) 78.68±11.76 85.29±25.60 63.24±12.73 52.65±21.40 54.41±21.79 71.69±23.30 83.33±25.62 55.44±22.97
≥40 80 (70.2) 68.81±20.72 75.78±27.69 59.63±18.45 53.36±22.03 53.36±22.03 70.47±22.35 75.83±28.73 59.00±19.86
t (p)   3.21 (.002) 1.71 (.089) 1.04 (.301) 0.84 (.400) 0.23 (.815) 0.26 (.792) 1.31 (.191) -0.83 (.406)
Gender Male 94 (82.5) 74.57±14.97 83.05±24.29 62.23±15.18 51.12±20.48 55.19±22.01 72.07±22.71 82.36±25.66 58.94±20.92
Female 20 (17.5) 58.50±28.75 57.81±31.60 53.50±22.77 45.75±19.42 46.56±20.22 65.00±21.31 57.92±30.04 53.25±20.08
t (p)   2.43 (.024) 3.99 (＜.001) 1.63 (.115) 1.07 (.285) 1.61 (.110) 1.27 (.204) 3.75 (＜.001) 1.11 (.269)
Spouse Yes 83 (72.8) 70.78±19.12 77.56±27.21 61.57±15.42 50.18±19.39 53.61±21.68 70.93±21.57 77.11±28.33 60.30±18.92
No 31 (27.2) 74.35±18.74 81.45±27.88 58.39±20.67 50.16±11.97 53.83±22.75 80.65±27.16 80.65±27.16 51.61±24.37
t (p)   -0.89 (.374) -0.67 (.501) 0.88 (.376) 0.00 (.996) -0.04 (.963) 0.07 (.938) -0.60 (.550) 2.01 (.047)
Education level ≤High school 54 (47.4) 69.07±22.53 74.54±28.73 57.96±19.46 48.15±19.94 49.54±21.78 69.21±24.25 73.61±29.26 53.61±21.90
≥College 60 (52.6) 74.17±14.93 82.29±25.68 63.17±14.08 52.00±20.65 57.40±21.45 72.29±20.98 82.08±26.30 61.83±19.11
t (p)   -1.43 (.163) -1.52 (.131) -1.62 (.109) -1.01 (.314) -1.93 (.055) -0.72 (.469) -1.61 (.108) -2.14 (.034)
Care provider Non-MP 91 (79.8) 70.49±20.49 78.09±28.90 60.22±17.13 49.78±20.98 51.85±22.33 68.68±23.15 78.57±28.41 57.58±21.30
MP 23 (20.2) 76.74±10.18 80.71±20.29 62.61±16.57 51.74±17.81 60.87±18.68 79.35±17.92 76.09±26.51 59.35±19.09
t (p)   -2.06 (.042) -0.40 (.684) -0.60 (.549) -0.41 (.681) -1.78 (.077) -2.05 (.042) 0.38 (.705) -0.36 (.718)
Occupation Yes 79 (69.3) 76.01±12.20 83.86±23.53 63.67±12.63 51.96±19.45 55.54±21.23 73.73±20.47 83.65±24.69 61.77±18.64
No 35 (30.7) 62.14±26.85 66.79±31.68 54.00±22.91 46.14±21.90 49.46±23.01 64.29±25.75 65.48±30.99 49.29±23.01
t (p)   2.92 (.006) 2.85 (.006) 2.34 (.024) 1.41 (.159) 1.37 (.172) 2.09 (.038) 3.06 (.003) 3.06 (.003)
Monthly income (10,000 won) ＜100a 31 (27.2) 65.32±23.38 68.15±30.63 54.19±22.92 42.10±22.57 43.95±25.84 60.08±26.30 67.47±31.43 43.87±22.65
100~199b 34 (29.8) 72.06±22.06 80.70±27.54 63.24±14.08 52.94±17.71 55.15±19.25 75.74±20.86 80.64±26.33 60.29±20.07
200~299c 20 (17.6) 76.75±9.22 78.44±22.44 64.50±10.50 51.25±19.73 54.06±19.90 72.50±18.41 77.92±26.39 62.00±13.02
≥300d 29 (25.4) 74.83±12.92 87.50±23.74 62.07±14.97 54.82±19.52 62.07±18.14 75.43±19.62 86.49±24.44 67.41±16.62
F (p)   1.94 (.126) 2.72 (.048) 2.24 (.088) 2.46 (.066) 3.78 (.013) 3.55 (.017) 2.56 (.058) 8.56 (＜.001)
Scheffé           a＜d a＜b   a＜b＜c＜d
Drinking Yes 19 (16.7) 77.63±9.33 84.54±24.68 64.21±10.17 52.11±17.90 56.25±22.05 73.06±23.30 85.96±19.26 61.58±20.35
No 95 (83.3) 70.58±20.22 77.43±27.79 60.00±17.98 49.79±20.83 53.16±21.92 70.39±22.48 76.49±29.20 57.21±20.92
t (p)   2.36 (.021) 1.03 (.303) 0.98 (.326) 0.45 (.652) 0.56 (.576) 0.46 (.655) 1.77 (.084) 0.83 (.406)
Concomitant disease Yes 54 (47.4) 64.81±21.67 69.21±31.12 56.30±21.57 45.74±21.42 50.58±23.95 68.52±26.23 70.22±30.53 54.44±23.04
No 60 (52.6) 78.00±13.63 87.08±20.16 64.67±9.99 54.17±18.55 56.46±19.59 72.92±18.58 85.14±23.47 61.08±18.18
t (p)   -3.83 (＜.001) -3.59 (.001) -2.61 (.011) -2.25 (.026) -1.44 (.153) -1.02 (.309) -2.90 (.005) -1.71 (.089)
Aggravation of disease Seriousa 4 (3.5) 72.33±18.64 79.55±26.77 60.97±16.77 54.55±21.27 54.55±21.27 71.11±22.14 79.69±25.95 58.78±19.87
Moderateb 7 (6.1) 62.50±26.29 40.62±27.71 45.00±25.16 32.81±20.00 32.81±20.00 46.87±32.87 18.75±23.93 28.75±16.52
Stablec 103 (90.4) 77.50±9.57 90.62±10.82 62.50±15.00 48.43±35.85 48.43±35.85 78.12±18.75 93.75±7.97 58.75±35.91
F (p)   1.70 (.499) 4.58 (.012) 1.72 (.183) 2.03 (.136) 2.03 (.136) 2.49 (.088) 11.72 (＜.001) 4.17 (.018)
Scheffé     c, a＞b         c, a＞b  

PF=physical function; RP=role physical; BP=bodily pain; GH=general health; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; MP=Medical personnel.

Table 4.
Liver Disease Targeted Scales of LDQOL according to General Characteristics and Clinical Characteristics (N=114)
Characteristics Categories n (%) Liver disease target scale of LDQOL
Total SxLD ELD Concentration Memory QSI HD SFun SProb Sleep Loneliness Hopeless SLD
M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD
Age (year) ＜40 34 (29.8) 81.31±10.62 87.72±14.73 85.55±13.22 94.62±10.66 95.69±10.68 79.41±12.34 52.45±13.32 85.97±12.52 93.14±11.87 67.88±19.26 96.24±17.57 73.38±20.07 79.71±18.54
≥40 80 (70.2) 80.16±9.58 87.48±14.60 81.44±11.98 92.46±13.05 89.50±14.47 81.20±12.17 54.25±11.80 78.75±17.48 86.02±16.98 72.00±14.76 85.15±14.42 71.38±18.49 84.79±18.70
t (p)   0.56 (.574) 0.08 (.936) 1.62 (.108) 0.85 (.397) 2.53 (.013) -0.71 (.476) -0.71 (.475) 2.48 (.015) 1.96 (.057) -1.24 (.217) 0.34 (.732) 0.51 (.606) -1.33 (.186)
Gender Male 94 (82.5) 81.03±9.83 89.11±13.57 84.08±12.15 94.76±9.98 93.30±10.61 79.62±12.08 54.93±11.51 80.23±17.13 87.62±16.04 70.98±16.86 85.49±15.39 72.13±18.28 82.27±19.30
Female 20 (17.5) 78.02±2.22 80.20±17.12 76.03±11.97 85.43±18.68 82.17±21.39 85.60±11.78 48.00±14.16 88.00±15.19 87.50±19.54 69.80±13.39 85.40±15.59 71.25±22.12 88.00±15.19
t (p)   1.24 (.217) 2.54 (.012) 2.69 (.008) 2.16 (.042) 2.26 (.034) -2.05 (.049) 2.34 (.021) -.94 (.345) 0.01 (.986) 0.29 (.770) 0.02 (.981) 0.18 (.851) -1.45 (.155)
Spouse Yes 83 (72.8) 80.70±9.23 88.27±13.28 81.99±12.30 93.08±12.48 90.88±13.23 81.11±12.10 54.74±11.47 80.26±16.08 87.50±16.33 72.67±14.69 85.49±14.30 71.39±18.42 83.29±19.30
No 31 (27.2) 79.98±11.56 85.61±17.68 84.48±12.87 93.18±12.32 92.58±15.05 79.48±12.55 50.97±13.94 82.63±17.53 88.19±16.07 65.68±19.20 85.42±18.14 73.55±20.38 83.23±17.35
t (p)   0.34 (.729) 0.86 (.388) -0.95 (.344) -0.03 (.970) -0.58 (.559) 0.63 (.529) 1.47 (.144) -0.68 (.496) -0.13 (.893) 2.07 (.040) 0.02 (.982) -0.54 (.589) 0.01 (.986)
Education level ≤High school 54 (47.4) 79.69±10.16 85.60±14.57 81.26±11.40 91.48±14.65 87.72±16.25 80.52±14.39 53.02±12.49 79.97±17.62 87.50±17.42 72.44±17.02 85.93±13.56 69.17±19.13 85.37±18.55
≥College 60 (52.6) 81.24±9.63 89.30±14.49 83.94±13.29 94.57±9.81 94.61±9.97 80.80±9.93 54.33±12.08 81.74±15.40 87.71±15.21 69.27±15.53 85.07±16.90 74.50±18.50 81.39±18.82
t (p)   -0.83 (.406) -1.35 (.178) -1.14 (.253) -1.30 (.194) -2.69 (.008) -0.12 (.905) -0.56 (.571) -0.57 (.570) -0.05 (.956) 1.04 (.299) 0.29 (.767) -1.51 (.133) 1.13 (.259)
Care provider Non-MP 91 (79.8) 79.84±10.33 86.66±14.74 82.25±13.23 92.18±13.12 91.50±13.79 79.30±12.26 53.63±12.50 80.91±17.10 86.26±17.14 69.89±16.47 84.92±15.75 71.65±19.21 81.61±19.83
MP 23 (20.2) 83.12±7.40 91.05±13.64 84.33±8.76 96.77±8.10 90.72±13.63 86.09±10.51 54.06±11.41 80.87±13.87 91.67±12.42 74.26±15.20 87.65±13.75 73.26±18.00 89.86±11.57
t (p)   -1.43 (.155) -1.29 (.199) -.71 (.475) -2.10 (.040) 0.24 (.809) -2.43 (.016) -0.15 (.881) 0.01 (.992) -1.26 (.209) -1.15 (.251) -0.76 (.449) -0.36 (.716) -2.58 (.012)
Occupation Yes 79 (69.3) 81.81±9.54 89.70±12.09 85.27±10.09 94.47±10.57 92.83±11.32 80.30±12.12 55.49±10.92 82.28±14.72 88.06±16.05 70.94±15.31 85.97±14.85 74.18±18.46 83.88±19.05
No 35 (30.7) 77.55±10.09 82.69±18.32 76.80±15.17 90.04±15.47 88.00±17.70 81.49±12.50 49.71±14.17 77.80±19.67 85.94±17.14 70.40±18.44 84.34±16.59 67.00±19.22 81.90±18.14
t (p)   2.16 (.033) 2.07 (.044) 3.51 (.001) 1.54 (.130) 1.48 (.144) -0.47 (.635) 2.14 (.037) 1.34 (.181) 0.46 (.645) 0.16 (.872) 0.52 (.603) 1.89 (.061) 0.51 (.605)
Monthly income (10,000 won) ＜100a 31 (27.2) 75.25±11.47 81.69±17.18 75.47±15.28 88.48±16.04 87.74±17.14 77.55±15.75 46.88±15.51 76.87±20.45 84.62±17.95 65.55±20.20 80.39±20.82 65.00±20.94 78.39±18.62
100~199b 34 (29.8) 82.26±7.71 88.32±13.68 84.99±10.06 94.12±11.05 90.69±14.26 83.64±10.76 56.18±9.57 80.88±14.98 85.00±18.94 76.00±11.36 88.71±9.82 75.15±14.64 84.12±18.98
200~299c 20 (17.6) 82.10±7.29 92.40±7.51 84.48±10.05 96.14±7.60 95.00±7.98 78.80±9.0 54.83±7.68 82.93±12.84 89.74±1.67 69.80±14.36 86.40±13.76 71.00±18.89 86.33±16.75
≥300d 29 (25.4) 80.50±9.87 89.55±14.92 86.39±10.35 94.79±11.20 93.45±11.46 81.79±10.83 57.36±11.18 83.84±15.38 90.67±13.46 70.90±16.52 86.48±14.20 76.38±19.77 85.40±19.71
F (p)   4.43 (.006) 2.74 (.046) 5.41 (.002) 2.16 (.097) 1.46 (.229) 1.61 (.189) 5.08 (.002) 1.03 (.381) 0.72 (.538) 2.34 (.077) 1.73 (.164) 2.35 (.076) 1.03 (.382)
Scheffé   a＜b, a＜d   a＜b, a＜d       a＜b, a＜d            
Drinking Yes 19 (16.7) 83.83±6.62 89.53±11.52 87.93±8.81 98.20±3.95 96.32±8.31 81.47±11.79 58.60±10.02 84.44±13.07 92.78±12.14 73.05±18.18 88.42±9.32 71.05±19.41 86.49±16.00
No 95 (83.3) 79.84±10.30 87.15±15.14 81.62±12.83 81.62±12.83 90.35±14.40 80.51±12.33 52.74±12.45 80.20±17.01 86.34±16.88 70.32±15.91 84.88±16.27 72.16±18.90 82.63±19.22
t (p)   1.62 (.108) 0.64 (.519) 2.04 (.043) 3.74 (＜.001) 2.47 (.017) 0.32 (.748) 1.92 (.056) 1.02 (.307) 1.69 (.102) 0.66 (.505) 1.30 (.199) -0.23 (.817) 0.81 (.414)
Concomitant disease Yes 54 (47.4) 78.81±11.73 84.55±18.10 78.67±14.10 91.85±13.39 88.33±15.86 80.67±13.07 52.16±13.51 77.65±20.59 85.75±18.57 71.78±16.03 83.33±15.94 70.46±20.36 83.40±21.83
No 60 (52.6) 82.03±7.62 90.25±9.86 86.26±9.52 94.24±11.39 94.06±10.86 80.67±11.46 55.11±10.90 83.83±10.89 89.47±13.38 69.87±16.54 87.40±14.67 73.33±17.56 83.17±15.58
t (p)   -1.71 (.089) -2.05 (.043) -3.40 (.001) -1.02 (.306) -2.22 (.029) 0.00 (1.000) -1.28 (.200) -1.97 (.052) -1.00 (.319) 0.62 (.533) -1.41 (.159) -0.80 (.421) 0.06 (.949)
Aggravation of disease f Seriousa 4 (3.5) 81.09±8.60 88.15±13.70 83.04±12.36 93.34±12.00 92.00±13.14 80.97±11.82 54.27±10.94 81.13±16.05 87.81±15.57 71.14±15.35 86.71±13.37 73.00±17.18 84.36±17.55
Moderateb 7 (6.1) 61.99±16.08 67.40±29.31 69.39±14.10 79.28±22.05 75.00±22.52 65.00±13.61 33.33±14.40 67.14±82.06 75.00±22.04 57.00±23.40 62.00±20.00 37.50±9.57 58.33±22.02
Stablec 103 (90.4) 82.89±19.14 91.17±12.47 84.91±11.29 95.71±8.57 93.33±9.42 82.00±15.49 53.33±26.66 92.14±1.42 100.00±.00 72.00±32.65 77.00±38.00 78.75±29.54 85.83±28.33
F (p)   8.18 (＜.001) 4.17 (.018) 2.47 (.095) 2.61 (.078) 3.18 (.045) 3.45 (.035) 6.09 (.003) 2.38 (.097) 1.93 (.152) 1.45 (.238) 6.02 (.003) 8.25 (＜.001) 4.02 (.021)
Scheffé   c, a＞b c, a＞b         a, c＞b       a＞b c＞b c＞b

LDQOL=Liver Disease Quality of Life; SxLD=symptoms of liver disease; ELD=effects of liver disease; QSI=quality of social interaction; HD=health distress; SFun=sexual function; SProb=sexual problems; SLD=stigma of liver disease; MP=Medical personnel.

Table 5.
Variables affecting SF-36 domains and Liver Disease Targeted Scales of LDQOL domain (N=114)
Variables LDQOL
SF-36 Liver disease target scale of LDQOL
PF RP BP VT SF RE MH SxLD ELD Conc Mem QSI HD SexFun
β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p)
Age -.23                         -.20
(.008)                         (.036)
Male .23 .35       .33   .23   .28 .32 -.20    
  (.014) (＜.001)       (＜.001)   (.013)   (.003) (.001) (.030)    
Income (high)       .19     .23              
      (.041)     (.017)              
Occupation (yes) .21   .27   .20   .20   .30       .23  
(.025)   (.004)   (.031)   (.041)   (.001)       (.014)  
Care provider .18       .20             .23    
(.041)       (.033)             (.010)    
F-statistics 7.76 15.93 8.55 4.278 4.74 14.09 8.03 6.31 11.21 9.44 12.58 5.75 6.17 4.45
p ＜.001 ＜.001 .004 .041 .011 ＜.001 .001 .013 .001 .003 .001 .004 .014 .0.36
R2 .22 .12 .07 .03 .08 .11 .12 .05 .09 .08 .10 .09 .05 .04

LDQOL=Liver disease quality of life; PF=physical function; RP=role physical; BP=bodily pain; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; SxLD=symptoms of liver disease; ELD=effects of liver disease; Conc=concentration; Mem=memory; QSI=quality of social interaction; HD=health distress; SFun=sexual function.

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    • Factors influencing on health-related quality of life in South Korean with chronic liver disease
      Hyun Jin Kim, Hyeonsik Chu, Seonhye Lee
      Health and Quality of Life Outcomes.2018;[Epub]     CrossRef
    • Quality of Life of Chronic Hepatitis C Patients and Its Associated Factors
      Hoo Jeung Cho, Euna Park
      Osong Public Health and Research Perspectives.2017; 8(2): 124.     CrossRef
    • Related Factors of Quality of Life in Middle-male with Chronic Liver Disease
      Eun-Su Do, Sun-Mi Lee, Young-Sook Seo
      Journal of Digital Convergence.2015; 13(2): 267.     CrossRef

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    Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B
    Korean J Adult Nurs. 2014;26(3):287-299.   Published online June 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.3.287
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    Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B
    Korean J Adult Nurs. 2014;26(3):287-299.   Published online June 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.3.287
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    Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B
    Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B

    General Characteristics, Health Behavior and Clinical Characteristics of Participants (N=114

    Characteristics Categories n (%) or M±SD
    Age (year) ＜40 34 (29.8)
    ≥40 80 (70.2)
    46.19±12.85
    Gender Male 94 (82.5)
    Female 20 (17.5)
    Spouse Yes 83 (72.8)
    No 31 (27.2)
    Education level Below high school 54 (47.4)
    Above college 60 (52.6)
    Religion Yes 62 (54.4)
    No 52 (45.6)
    Care provider Non-medical personnel 91 (79.8)
    Medical personnel 23 (20.2)
    Occupation Yes 79 (69.3)
    No 35 (30.7)
    Monthly income (10,000 won) ＜100 31 (27.2)
    100~199 34 (29.8)
    200~299 20 (17.6)
    ≥300 29 (25.4)
    Alcohol drinking Yes 19 (16.7)
    No 95 (83.3)
    Smoking Yes 24 (21.1)
    No 90 (78.9)
    Concomitant disease Yes 54 (47.4)
    No 60 (52.6)
    Aggravation of disease Serious (≥5 times ALT) 4 (3.5)
    Moderate (2~＜5 times ALT) 7 (6.1)
    Stable (＜2 times ALT) 103 (90.4)
    Drug resistance mutation Yes 57 (50.0)
    No 57 (50.0)
    Medication duration (year) ＜1 24 (21.0)
    1~＜3 28 (24.6)
    3~＜5 36 (31.6)
    ≥5 26 (22.8)
    Serum liver function test (normal range)    
      AST (7~40 U/L)   47.93±100.29
      ALT (5~57 U/L)   49.67±74.73
      Albumin (3.5~5.5 g/dL)   4.51±0.52
      Bilirubin (0.2~1.0 mg/dL)   2.98±16.98
      ALP (38~126 U/L)   64.11±25.32
      GGT (Male: 3~39 U/L, Female: 1~27 U/L)   63.45±93.96

    AST=aspartate transaminase; ALT=alanine transaminase; ALP=alkaline phosphatase; GGT=gamma glutamyl transpeptidase.

    SF-36 and Liver Disease Targeted Scales of LDQOL 1.0 (N=114)

    Variables M±SD Range
    SF-36 Physical functioning 71.75±19.00 0~85.00
    Role limitation-physical 78.62±27.32 0~100.00
    Bodily pain 60.70±16.97 0~70.00
    General health 50.18±20.32 0~95.00
    Vitality 53.67±21.87 0~93.75
    Social functioning 70.83±22.54 0~87.50
    Role limitation-emotion 57.94±20.80 0~100.00
    Mental health 65.22±17.60 0~85.00
    Liver Disease Targeted Scales of LDQOL Symptoms of liver disease 87.54±14.58 29.41~100.00
    Effects of liver disease 82.67±12.45 32.76~100.00
    Concentration 93.11±12.38 34.29~100.00
    Memory 91.35±13.70 30.00~100.00
    Quality of social interaction 80.67±12.19 36.00~100.00
    Health distress 53.71±12.24 13.33~66.67
    Sexual functioning 80.90±16.44 20.00~100.00
    Sexual problems (n=76) 87.61±16.19 41.67~100.00
    Sleep 70.77±16.26 24.00~100.00
    Loneliness 85.47±15.35 20.00~100.00
    Hopelessness 71.97±18.90 30.00~100.00
    Stigma of liver disease 83.27±18.71 20.00~100.00

    LDQOL=liver disease quality of life.

    SF-36 according to General Characteristics and Clinical Characteristics (N=114)

    Characteristics Categories n (%) SF-36
    PF RP BP GH VT SF RE MH
    M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD
    Age (year) ＜40 34 (29.8) 78.68±11.76 85.29±25.60 63.24±12.73 52.65±21.40 54.41±21.79 71.69±23.30 83.33±25.62 55.44±22.97
    ≥40 80 (70.2) 68.81±20.72 75.78±27.69 59.63±18.45 53.36±22.03 53.36±22.03 70.47±22.35 75.83±28.73 59.00±19.86
    t (p)   3.21 (.002) 1.71 (.089) 1.04 (.301) 0.84 (.400) 0.23 (.815) 0.26 (.792) 1.31 (.191) -0.83 (.406)
    Gender Male 94 (82.5) 74.57±14.97 83.05±24.29 62.23±15.18 51.12±20.48 55.19±22.01 72.07±22.71 82.36±25.66 58.94±20.92
    Female 20 (17.5) 58.50±28.75 57.81±31.60 53.50±22.77 45.75±19.42 46.56±20.22 65.00±21.31 57.92±30.04 53.25±20.08
    t (p)   2.43 (.024) 3.99 (＜.001) 1.63 (.115) 1.07 (.285) 1.61 (.110) 1.27 (.204) 3.75 (＜.001) 1.11 (.269)
    Spouse Yes 83 (72.8) 70.78±19.12 77.56±27.21 61.57±15.42 50.18±19.39 53.61±21.68 70.93±21.57 77.11±28.33 60.30±18.92
    No 31 (27.2) 74.35±18.74 81.45±27.88 58.39±20.67 50.16±11.97 53.83±22.75 80.65±27.16 80.65±27.16 51.61±24.37
    t (p)   -0.89 (.374) -0.67 (.501) 0.88 (.376) 0.00 (.996) -0.04 (.963) 0.07 (.938) -0.60 (.550) 2.01 (.047)
    Education level ≤High school 54 (47.4) 69.07±22.53 74.54±28.73 57.96±19.46 48.15±19.94 49.54±21.78 69.21±24.25 73.61±29.26 53.61±21.90
    ≥College 60 (52.6) 74.17±14.93 82.29±25.68 63.17±14.08 52.00±20.65 57.40±21.45 72.29±20.98 82.08±26.30 61.83±19.11
    t (p)   -1.43 (.163) -1.52 (.131) -1.62 (.109) -1.01 (.314) -1.93 (.055) -0.72 (.469) -1.61 (.108) -2.14 (.034)
    Care provider Non-MP 91 (79.8) 70.49±20.49 78.09±28.90 60.22±17.13 49.78±20.98 51.85±22.33 68.68±23.15 78.57±28.41 57.58±21.30
    MP 23 (20.2) 76.74±10.18 80.71±20.29 62.61±16.57 51.74±17.81 60.87±18.68 79.35±17.92 76.09±26.51 59.35±19.09
    t (p)   -2.06 (.042) -0.40 (.684) -0.60 (.549) -0.41 (.681) -1.78 (.077) -2.05 (.042) 0.38 (.705) -0.36 (.718)
    Occupation Yes 79 (69.3) 76.01±12.20 83.86±23.53 63.67±12.63 51.96±19.45 55.54±21.23 73.73±20.47 83.65±24.69 61.77±18.64
    No 35 (30.7) 62.14±26.85 66.79±31.68 54.00±22.91 46.14±21.90 49.46±23.01 64.29±25.75 65.48±30.99 49.29±23.01
    t (p)   2.92 (.006) 2.85 (.006) 2.34 (.024) 1.41 (.159) 1.37 (.172) 2.09 (.038) 3.06 (.003) 3.06 (.003)
    Monthly income (10,000 won) ＜100a 31 (27.2) 65.32±23.38 68.15±30.63 54.19±22.92 42.10±22.57 43.95±25.84 60.08±26.30 67.47±31.43 43.87±22.65
    100~199b 34 (29.8) 72.06±22.06 80.70±27.54 63.24±14.08 52.94±17.71 55.15±19.25 75.74±20.86 80.64±26.33 60.29±20.07
    200~299c 20 (17.6) 76.75±9.22 78.44±22.44 64.50±10.50 51.25±19.73 54.06±19.90 72.50±18.41 77.92±26.39 62.00±13.02
    ≥300d 29 (25.4) 74.83±12.92 87.50±23.74 62.07±14.97 54.82±19.52 62.07±18.14 75.43±19.62 86.49±24.44 67.41±16.62
    F (p)   1.94 (.126) 2.72 (.048) 2.24 (.088) 2.46 (.066) 3.78 (.013) 3.55 (.017) 2.56 (.058) 8.56 (＜.001)
    Scheffé           a＜d a＜b   a＜b＜c＜d
    Drinking Yes 19 (16.7) 77.63±9.33 84.54±24.68 64.21±10.17 52.11±17.90 56.25±22.05 73.06±23.30 85.96±19.26 61.58±20.35
    No 95 (83.3) 70.58±20.22 77.43±27.79 60.00±17.98 49.79±20.83 53.16±21.92 70.39±22.48 76.49±29.20 57.21±20.92
    t (p)   2.36 (.021) 1.03 (.303) 0.98 (.326) 0.45 (.652) 0.56 (.576) 0.46 (.655) 1.77 (.084) 0.83 (.406)
    Concomitant disease Yes 54 (47.4) 64.81±21.67 69.21±31.12 56.30±21.57 45.74±21.42 50.58±23.95 68.52±26.23 70.22±30.53 54.44±23.04
    No 60 (52.6) 78.00±13.63 87.08±20.16 64.67±9.99 54.17±18.55 56.46±19.59 72.92±18.58 85.14±23.47 61.08±18.18
    t (p)   -3.83 (＜.001) -3.59 (.001) -2.61 (.011) -2.25 (.026) -1.44 (.153) -1.02 (.309) -2.90 (.005) -1.71 (.089)
    Aggravation of disease Seriousa 4 (3.5) 72.33±18.64 79.55±26.77 60.97±16.77 54.55±21.27 54.55±21.27 71.11±22.14 79.69±25.95 58.78±19.87
    Moderateb 7 (6.1) 62.50±26.29 40.62±27.71 45.00±25.16 32.81±20.00 32.81±20.00 46.87±32.87 18.75±23.93 28.75±16.52
    Stablec 103 (90.4) 77.50±9.57 90.62±10.82 62.50±15.00 48.43±35.85 48.43±35.85 78.12±18.75 93.75±7.97 58.75±35.91
    F (p)   1.70 (.499) 4.58 (.012) 1.72 (.183) 2.03 (.136) 2.03 (.136) 2.49 (.088) 11.72 (＜.001) 4.17 (.018)
    Scheffé     c, a＞b         c, a＞b  

    PF=physical function; RP=role physical; BP=bodily pain; GH=general health; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; MP=Medical personnel.

    Liver Disease Targeted Scales of LDQOL according to General Characteristics and Clinical Characteristics (N=114)

    Characteristics Categories n (%) Liver disease target scale of LDQOL
    Total SxLD ELD Concentration Memory QSI HD SFun SProb Sleep Loneliness Hopeless SLD
    M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD M±SD
    Age (year) ＜40 34 (29.8) 81.31±10.62 87.72±14.73 85.55±13.22 94.62±10.66 95.69±10.68 79.41±12.34 52.45±13.32 85.97±12.52 93.14±11.87 67.88±19.26 96.24±17.57 73.38±20.07 79.71±18.54
    ≥40 80 (70.2) 80.16±9.58 87.48±14.60 81.44±11.98 92.46±13.05 89.50±14.47 81.20±12.17 54.25±11.80 78.75±17.48 86.02±16.98 72.00±14.76 85.15±14.42 71.38±18.49 84.79±18.70
    t (p)   0.56 (.574) 0.08 (.936) 1.62 (.108) 0.85 (.397) 2.53 (.013) -0.71 (.476) -0.71 (.475) 2.48 (.015) 1.96 (.057) -1.24 (.217) 0.34 (.732) 0.51 (.606) -1.33 (.186)
    Gender Male 94 (82.5) 81.03±9.83 89.11±13.57 84.08±12.15 94.76±9.98 93.30±10.61 79.62±12.08 54.93±11.51 80.23±17.13 87.62±16.04 70.98±16.86 85.49±15.39 72.13±18.28 82.27±19.30
    Female 20 (17.5) 78.02±2.22 80.20±17.12 76.03±11.97 85.43±18.68 82.17±21.39 85.60±11.78 48.00±14.16 88.00±15.19 87.50±19.54 69.80±13.39 85.40±15.59 71.25±22.12 88.00±15.19
    t (p)   1.24 (.217) 2.54 (.012) 2.69 (.008) 2.16 (.042) 2.26 (.034) -2.05 (.049) 2.34 (.021) -.94 (.345) 0.01 (.986) 0.29 (.770) 0.02 (.981) 0.18 (.851) -1.45 (.155)
    Spouse Yes 83 (72.8) 80.70±9.23 88.27±13.28 81.99±12.30 93.08±12.48 90.88±13.23 81.11±12.10 54.74±11.47 80.26±16.08 87.50±16.33 72.67±14.69 85.49±14.30 71.39±18.42 83.29±19.30
    No 31 (27.2) 79.98±11.56 85.61±17.68 84.48±12.87 93.18±12.32 92.58±15.05 79.48±12.55 50.97±13.94 82.63±17.53 88.19±16.07 65.68±19.20 85.42±18.14 73.55±20.38 83.23±17.35
    t (p)   0.34 (.729) 0.86 (.388) -0.95 (.344) -0.03 (.970) -0.58 (.559) 0.63 (.529) 1.47 (.144) -0.68 (.496) -0.13 (.893) 2.07 (.040) 0.02 (.982) -0.54 (.589) 0.01 (.986)
    Education level ≤High school 54 (47.4) 79.69±10.16 85.60±14.57 81.26±11.40 91.48±14.65 87.72±16.25 80.52±14.39 53.02±12.49 79.97±17.62 87.50±17.42 72.44±17.02 85.93±13.56 69.17±19.13 85.37±18.55
    ≥College 60 (52.6) 81.24±9.63 89.30±14.49 83.94±13.29 94.57±9.81 94.61±9.97 80.80±9.93 54.33±12.08 81.74±15.40 87.71±15.21 69.27±15.53 85.07±16.90 74.50±18.50 81.39±18.82
    t (p)   -0.83 (.406) -1.35 (.178) -1.14 (.253) -1.30 (.194) -2.69 (.008) -0.12 (.905) -0.56 (.571) -0.57 (.570) -0.05 (.956) 1.04 (.299) 0.29 (.767) -1.51 (.133) 1.13 (.259)
    Care provider Non-MP 91 (79.8) 79.84±10.33 86.66±14.74 82.25±13.23 92.18±13.12 91.50±13.79 79.30±12.26 53.63±12.50 80.91±17.10 86.26±17.14 69.89±16.47 84.92±15.75 71.65±19.21 81.61±19.83
    MP 23 (20.2) 83.12±7.40 91.05±13.64 84.33±8.76 96.77±8.10 90.72±13.63 86.09±10.51 54.06±11.41 80.87±13.87 91.67±12.42 74.26±15.20 87.65±13.75 73.26±18.00 89.86±11.57
    t (p)   -1.43 (.155) -1.29 (.199) -.71 (.475) -2.10 (.040) 0.24 (.809) -2.43 (.016) -0.15 (.881) 0.01 (.992) -1.26 (.209) -1.15 (.251) -0.76 (.449) -0.36 (.716) -2.58 (.012)
    Occupation Yes 79 (69.3) 81.81±9.54 89.70±12.09 85.27±10.09 94.47±10.57 92.83±11.32 80.30±12.12 55.49±10.92 82.28±14.72 88.06±16.05 70.94±15.31 85.97±14.85 74.18±18.46 83.88±19.05
    No 35 (30.7) 77.55±10.09 82.69±18.32 76.80±15.17 90.04±15.47 88.00±17.70 81.49±12.50 49.71±14.17 77.80±19.67 85.94±17.14 70.40±18.44 84.34±16.59 67.00±19.22 81.90±18.14
    t (p)   2.16 (.033) 2.07 (.044) 3.51 (.001) 1.54 (.130) 1.48 (.144) -0.47 (.635) 2.14 (.037) 1.34 (.181) 0.46 (.645) 0.16 (.872) 0.52 (.603) 1.89 (.061) 0.51 (.605)
    Monthly income (10,000 won) ＜100a 31 (27.2) 75.25±11.47 81.69±17.18 75.47±15.28 88.48±16.04 87.74±17.14 77.55±15.75 46.88±15.51 76.87±20.45 84.62±17.95 65.55±20.20 80.39±20.82 65.00±20.94 78.39±18.62
    100~199b 34 (29.8) 82.26±7.71 88.32±13.68 84.99±10.06 94.12±11.05 90.69±14.26 83.64±10.76 56.18±9.57 80.88±14.98 85.00±18.94 76.00±11.36 88.71±9.82 75.15±14.64 84.12±18.98
    200~299c 20 (17.6) 82.10±7.29 92.40±7.51 84.48±10.05 96.14±7.60 95.00±7.98 78.80±9.0 54.83±7.68 82.93±12.84 89.74±1.67 69.80±14.36 86.40±13.76 71.00±18.89 86.33±16.75
    ≥300d 29 (25.4) 80.50±9.87 89.55±14.92 86.39±10.35 94.79±11.20 93.45±11.46 81.79±10.83 57.36±11.18 83.84±15.38 90.67±13.46 70.90±16.52 86.48±14.20 76.38±19.77 85.40±19.71
    F (p)   4.43 (.006) 2.74 (.046) 5.41 (.002) 2.16 (.097) 1.46 (.229) 1.61 (.189) 5.08 (.002) 1.03 (.381) 0.72 (.538) 2.34 (.077) 1.73 (.164) 2.35 (.076) 1.03 (.382)
    Scheffé   a＜b, a＜d   a＜b, a＜d       a＜b, a＜d            
    Drinking Yes 19 (16.7) 83.83±6.62 89.53±11.52 87.93±8.81 98.20±3.95 96.32±8.31 81.47±11.79 58.60±10.02 84.44±13.07 92.78±12.14 73.05±18.18 88.42±9.32 71.05±19.41 86.49±16.00
    No 95 (83.3) 79.84±10.30 87.15±15.14 81.62±12.83 81.62±12.83 90.35±14.40 80.51±12.33 52.74±12.45 80.20±17.01 86.34±16.88 70.32±15.91 84.88±16.27 72.16±18.90 82.63±19.22
    t (p)   1.62 (.108) 0.64 (.519) 2.04 (.043) 3.74 (＜.001) 2.47 (.017) 0.32 (.748) 1.92 (.056) 1.02 (.307) 1.69 (.102) 0.66 (.505) 1.30 (.199) -0.23 (.817) 0.81 (.414)
    Concomitant disease Yes 54 (47.4) 78.81±11.73 84.55±18.10 78.67±14.10 91.85±13.39 88.33±15.86 80.67±13.07 52.16±13.51 77.65±20.59 85.75±18.57 71.78±16.03 83.33±15.94 70.46±20.36 83.40±21.83
    No 60 (52.6) 82.03±7.62 90.25±9.86 86.26±9.52 94.24±11.39 94.06±10.86 80.67±11.46 55.11±10.90 83.83±10.89 89.47±13.38 69.87±16.54 87.40±14.67 73.33±17.56 83.17±15.58
    t (p)   -1.71 (.089) -2.05 (.043) -3.40 (.001) -1.02 (.306) -2.22 (.029) 0.00 (1.000) -1.28 (.200) -1.97 (.052) -1.00 (.319) 0.62 (.533) -1.41 (.159) -0.80 (.421) 0.06 (.949)
    Aggravation of disease f Seriousa 4 (3.5) 81.09±8.60 88.15±13.70 83.04±12.36 93.34±12.00 92.00±13.14 80.97±11.82 54.27±10.94 81.13±16.05 87.81±15.57 71.14±15.35 86.71±13.37 73.00±17.18 84.36±17.55
    Moderateb 7 (6.1) 61.99±16.08 67.40±29.31 69.39±14.10 79.28±22.05 75.00±22.52 65.00±13.61 33.33±14.40 67.14±82.06 75.00±22.04 57.00±23.40 62.00±20.00 37.50±9.57 58.33±22.02
    Stablec 103 (90.4) 82.89±19.14 91.17±12.47 84.91±11.29 95.71±8.57 93.33±9.42 82.00±15.49 53.33±26.66 92.14±1.42 100.00±.00 72.00±32.65 77.00±38.00 78.75±29.54 85.83±28.33
    F (p)   8.18 (＜.001) 4.17 (.018) 2.47 (.095) 2.61 (.078) 3.18 (.045) 3.45 (.035) 6.09 (.003) 2.38 (.097) 1.93 (.152) 1.45 (.238) 6.02 (.003) 8.25 (＜.001) 4.02 (.021)
    Scheffé   c, a＞b c, a＞b         a, c＞b       a＞b c＞b c＞b

    LDQOL=Liver Disease Quality of Life; SxLD=symptoms of liver disease; ELD=effects of liver disease; QSI=quality of social interaction; HD=health distress; SFun=sexual function; SProb=sexual problems; SLD=stigma of liver disease; MP=Medical personnel.

    Variables affecting SF-36 domains and Liver Disease Targeted Scales of LDQOL domain (N=114)

    Variables LDQOL
    SF-36 Liver disease target scale of LDQOL
    PF RP BP VT SF RE MH SxLD ELD Conc Mem QSI HD SexFun
    β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p) β (p)
    Age -.23                         -.20
    (.008)                         (.036)
    Male .23 .35       .33   .23   .28 .32 -.20    
      (.014) (＜.001)       (＜.001)   (.013)   (.003) (.001) (.030)    
    Income (high)       .19     .23              
          (.041)     (.017)              
    Occupation (yes) .21   .27   .20   .20   .30       .23  
    (.025)   (.004)   (.031)   (.041)   (.001)       (.014)  
    Care provider .18       .20             .23    
    (.041)       (.033)             (.010)    
    F-statistics 7.76 15.93 8.55 4.278 4.74 14.09 8.03 6.31 11.21 9.44 12.58 5.75 6.17 4.45
    p ＜.001 ＜.001 .004 .041 .011 ＜.001 .001 .013 .001 .003 .001 .004 .014 .0.36
    R2 .22 .12 .07 .03 .08 .11 .12 .05 .09 .08 .10 .09 .05 .04

    LDQOL=Liver disease quality of life; PF=physical function; RP=role physical; BP=bodily pain; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; SxLD=symptoms of liver disease; ELD=effects of liver disease; Conc=concentration; Mem=memory; QSI=quality of social interaction; HD=health distress; SFun=sexual function.
    Table 1. General Characteristics, Health Behavior and Clinical Characteristics of Participants (N=114

    AST=aspartate transaminase; ALT=alanine transaminase; ALP=alkaline phosphatase; GGT=gamma glutamyl transpeptidase.

    Table 2. SF-36 and Liver Disease Targeted Scales of LDQOL 1.0 (N=114)

    LDQOL=liver disease quality of life.

    Table 3. SF-36 according to General Characteristics and Clinical Characteristics (N=114)

    PF=physical function; RP=role physical; BP=bodily pain; GH=general health; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; MP=Medical personnel.

    Table 4. Liver Disease Targeted Scales of LDQOL according to General Characteristics and Clinical Characteristics (N=114)

    LDQOL=Liver Disease Quality of Life; SxLD=symptoms of liver disease; ELD=effects of liver disease; QSI=quality of social interaction; HD=health distress; SFun=sexual function; SProb=sexual problems; SLD=stigma of liver disease; MP=Medical personnel.

    Table 5. Variables affecting SF-36 domains and Liver Disease Targeted Scales of LDQOL domain (N=114)

    LDQOL=Liver disease quality of life; PF=physical function; RP=role physical; BP=bodily pain; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; SxLD=symptoms of liver disease; ELD=effects of liver disease; Conc=concentration; Mem=memory; QSI=quality of social interaction; HD=health distress; SFun=sexual function.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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