Factors Affecting Anxiety, Depression, and Self-care Ability in Patients Who Have Undergone Liver Transplantation

Background: Depression, anxiety, and altered self-care ability are among the most important factors affecting the quality of life of liver transplant recipients. Depending on the severity of the underlying liver disease, signs and symptoms of anxiety and depression may become more pronounced.

Aim: To evaluate the factors affecting depression, anxiety and self-care abilities of liver transplant recipients.

Methods: Recipients who are ≥ 18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional study. Sample size analysis showed that the minimum number of recipients should be 301 (confidence level = 95%, confidence interval = 2.5, population = 1382). Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were analyzed. The dependent variables were the Beck Depression Scale, State-Trait Anxiety Scale (Form I and II), and Self-Care Agency Scale. The independent variables of the study were sociodemographic characteristics, biliary complications, hepatocellular carcinoma, recommending liver transplantation to other patients, and the interval of out-patient clinic visits.

Results: Self-care ability scores were lower ( = 0.002) and anxiety scores were higher ( = 0.004) in recipients with biliary complications. On the other hand, in recipients with hepatocellular carcinoma, self-care scores were lower ( = 0.006) while depression ( = 0.003) and anxiety scores ( = 0.009) were higher. Liver transplantation recipients with a monthly income < 3000 Turkish liras had higher depression ( < 0.001) and anxiety ( = 0.003) scores. The recipients who stated that they would not recommend liver transplantation to others had lower self-care scores ( = 0.002), higher depression ( < 0.001), higher state anxiety ( = 0.02), and trait anxiety ( < 0.001) scores.

Conclusion: Presence of biliary complications and hepatocellular carcinoma, low income level, and an obligation for monthly visits to the outpatient clinic are factors that are found to affect self-care capability, depression, and anxiety.