Relation between self-perceived burden and quality of life in liver transplant recipients： the effecting path of anxiety and depression

Abstract

BackgroundSelf-perceived burden， anxiety and depression are among the most important factors affecting quality of life. At present， there is a lack of understanding on the research status and influencing factors of self-perceived burden in liver transplant recipients. Previous studies have shown that self-perceived burden， anxiety， depression and quality of life are correlated in pairs， but the effecting path among the three are not yet clear.ObjectiveTo explore the correlation of self-perceived burden and anxiety/depression with quality of life in liver transplant recipients， so as to provide guidance for psychological nursing intervention in clinical patients.MethodsA total of 200 patients liver transplant recipients were enrolled from the liver transplantation inpatient and outpatient clinics of Jiangsu Province Hospital and Qinhuai Medical Area， General Hosptial of Eastern Theater Command of People's Liberation Army of China from March 2022 to February 2023. Patients were evaluated using Self-perceived Burden Scale （SPBS）， Hospital Anxiety and Depression Scale （HADS） and the Chinese version of Post Liver Transplant Quality of Life Questionnaire （pLTQ）. Spearman correlation analysis was used to examine the correlation among the scales. A structural equation model using Mplus 8.3 was utilized to testify the relationship among self-perceived burden， anxiety/depression and quality of life in liver transplant recipients. Bootstrap method was used to test the effecting pathway.ResultsThere were statistically significant differences in SPBS scores of liver transplant recipients with different levels of education and fannual family income （H=9.656， 18.796， P<0.05）. There were statistically significant differences in HADS scores of liver transplant recipients with different numbers of somatic symptoms （H=9.859， P<0.05）. There were statistically significant differences in the Chinese version of pLTQ scores of liver transplant recipients with different levels of education， postoperative survival time and numbers of somatic symptoms （H= 6.892， 8.023， 16.099， P<0.05）. The total and each dimension scores in SPBS of liver transplant recipients were positively correlated with the total score and anxiety/depression dimension scores in HADS （r=0.464~0.586， 0.460~0.593， 0.286~0.408， 0.464~0.583， P<0.01） and negatively correlated with the total score and each dimension scores in the Chinese version of pLTQ （r=-0.572~-0.416， -0.599~-0.441， -0.365~-0.213， -0.559~-0.428， P<0.01）. Structural equation model denoted that self-perceived burden negatively affected quality of life （β=-0.186， P<0.01）. Anxiety/depression also negatively affected quality of life （β=-0.679， P<0.01）. The self-perceived burden indirectly affected the quality of life of liver transplant recipients through anxiety and depression， with an effect value of -0.429， accounting for 69.76% of the total effect.ConclusionThe quality of life in liver transplant recipients may be related to their self-perceived burden and anxiety/depression. Self-perceived burden may affect the quality of life of liver transplant patients through anxiety and depression.［Funded by Jiangsu Province Hospital "Clinical Ability Enhancement" Nursing Project in 2021 （number， JSPH-NC-2021-18）］

Keywords

• liver transplantation
• self-perceived burden
• anxiety
• depression
• quality of life