Study On The Status Of Fatigue In Liver Transplant Recipients And Its Related Factors

Objective:(1) to describe the status of fatigue among liver transplant recipients; and (2) to explore the physiological factors, psychological factors and environmental factors related to the fatigue in liver transplant recipients and to provide a theoretical basis for intervention in the treatment of fatigue in liver transplant recipients.Methods:From April to November 2015, a cross-sectional survey research method was carried out in liver transplant follow-up clinic in Beijing YouAn Hospital, Capital Medical University. Using convenience sampling method, a total of 195 liver transplant recipients, complying with unified inclusion and exclusion criteria, were investigated with survey questionnaires including general questionnaire, Fatigue Symptom Inventory (FSI), the Chinese version of Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF-C), Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS) and the Multidimensional Scale of Perceived Social Support (MSPSS). SPSS 21.0 statistical software was used to analyze the data, and the statistical methods included descriptive statistics, Spearman correlation analysis, non-parametric test, and multiple stepwise regression analysis.Results:(1) the incidence of fatigue among 195 liver transplant recipients was 55.38%; the median number of days liver transplant recipients felt fatigue in the last week was 2, the median time they felt fatigue every day was 3; 9.75% of liver transplant recipients felt most fatigue in the morning,35.43% of liver transplant recipients in the afternoon,19.49% of liver transplant recipients in the evening, and 35.43% of liver transplant recipients felt the most fatigue time inconsistent every day.(2) the median score of fatigue intensity dimension in liver transplant recipients was 3.00 (P25=1.50, P75=4.75), the median score of fatigue interference with quality of life was 2.00 (P25=0.57, P75=3.71). Fatigue had certain influence on their general level of activity, enjoyment of life, mood, relation with others, and ability to concentrate, while had little influence on their normal work activity, and ability to bathe and dress.(3) the median score of general fatigue, physical fatigue, emotional fatigue, mental fatigue, and vigor in liver transplant recipients were 4 (P25=1, P75=6),5 (P25=2, P75=8),2 (P25=1, P75=5),4 (P25=2, P75=6),13 (P25=9, P75=19); the median total score was 4 (P25=-9, P75=15).(4) Univariate analysis showed that gender, monthly family income, AST, serum albumin, serum calcium, anxiety, depression, insomnia and social support were related to one or more dimensions of fatigue in liver transplant recipients (P<0.05).(5) Multivariate analysis showed that the main factors related to the intensity dimension of fatigue in liver transplant recipients were insomnia and anxiety, which explained 32.2% of the variance in fatigue intensity dimension; the main factors related to the time dimension of fatigue in liver transplant recipients were insomnia and depression, which explained 26.4% of the variance in fatigue time dimension; the main factors related to the distress dimension of fatigue in liver transplant recipients were insomnia and depression, which explained 36.6% of the variance in fatigue distress dimension.Conclusion:(1) the incidence of fatigue in liver transplant recipients was high, an average of 2 days a week fatigued, with majority of intermittent short fatigue. Most recipients felt the mostly fatigued in the afternoon or inconsistent everyday.(2) the intensity of fatigue in liver transplant recipients was mild to moderate, with mild interference on quality of life. Mental fatigue and physical fatigue were more intensive than emotional fatigue.(3) female liver transplant recipients felt fatigue more time than men; the more severe insomnia liver transplant recipients had, the more intense and longer fatigue they felt, and the greater interference caused by fatigue on the quality of life; liver transplant recipients with abnormal liver function indicators, including AST and albumin values, had more serious fatigue; liver transplant recipients with abnormal serum calcium felt greater interference on their quality of life caused by fatigue; the more severe anxiety and depression liver transplant recipients had, the more intense and longer fatigue they felt, and the greater interference caused by fatigue on the quality of life; liver transplant recipients with higher income had less fatigue time they felt; the higher social support liver transplant recipients perceived, the less fatigue intense and fatigue time they felt, and the less interference caused by fatigue on the quality of life.(4) insomnia and anxiety were the main factors of liver transplant recipients in fatigue intensity dimension; insomnia and depression were the main factors of liver transplant recipients in fatigue time dimension and fatigue distress dimension.