| Objective1. To describe liver transplant recipients'subjective assessment of their own quality of life(QOL).2. To describe recipients'QOL before and after liver transplantation in multi-dimensional aspects of QOL.3. To establish nursing interventions, based on the research outcome above, for improving QOL of liver transplant recipients (hereinafter referred to as patients).MethodsA qualitative analysis was done of 11 patients, who were rehabilitatively discharged, after liver transplantation prior to August 2006, from two Fuzhou municipal general hospitals, which are categorized as A of Grade Three ones. An investigation was thoroughly made into patients'QOL before and after liver transplantation. Data from the interviews were thus collected, processed and analyzed by means of research methods of phenomenology.Results1.Patients'subjective assessment of their own QOL: the best QOL the patients thought should include good health, familial happiness, substantial financial condition, and smooth job. The assessment of their own QOL was closely correlative to the frame of reference they had selected. The QOL patients had experienced was positive and satisfactory when compared with that in the past and with possibility of the potential development in the future, and was always found defective and insufficient when compared with higher life quality of the normal peers, thus leading to poorer quality of life. 2.Analysis of patients'QOL in different aspects⑴Physical health.①Before transplantation,physiological dis- comfort was elicited by symptoms and signs of the disease.②After transplanttation, discomfort was elicited by the surgical wound and physical problems from complication.⑵Psychological status.①Before transplantation,the negative psy- chological status dominated the patients'experience, including desire for survival,self-accusation,anxiety and fear,inferiority, desperation, etc.②After transplantation, patients'psychological experience consisted of both positive and negative psychological status, the positive including gentleness, optimism, gratefulness, etc. while the negative including dismay and disappointment, anxiety, tension and fear, depression, etc.⑶Capability of independence.①Before transplantation, self-care was not restricted during the phase of liver compensation while life-dependence developed during the phase of liver discompensation.②After transplantation, capability of self-care recovered basically and parts of patients had role of independent performance altered and self-control impaired.⑷Social functions.①Before transplantation, patients'social functions were close to the normal peers'during the phase of liver compensation while during the phase of liver discompensation to which liver disease had advanced,family role and social role were dis- satisfactory, need for dependence on others for survival developed, and subjective feeling was low.②After transplantation, patients with harmonious family, nice public relationship and their job resumed enjoyed better quality of life.⑸Living environment.①Before transplantation, patients'physical health deteriorated from bad to worse on the long way seeking for medical attention and patients underwent at the same time the extreme finical strain.②After transplantation, heavy financial burdens still existed; however, the physical health was greatly improved, better than pre-operation.⑹Religious belief and spiritual comfort. Studies revealed patients cherished spiritual comfort in one way or another including religious belief, self-assertion, fortune, and science and technology.Conclusions1. QOL of liver transplant recipients in all aspects improved to a certain extent, better than pre-operation; however, gap existed when comparison was made with normal peers'.2. Revelations this study has generated to nursing care are: study of QOL can serve as indicators for assessing nursing quality in clinical practice, provide basis for implementing effective nursing interventions for post-operative cases with liver transplant. Many methods can be adopted to improve patients'QOL, including paying attention to delivery of holistic psychological nursing to patients, cooperating with doctors to provide patients with good physiological adjustment before and after grafting, improving patients'capability in comprehensive self-care, and helping patients acquire support from their family and the society.
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