Journal of Korean Biological Nursing Science

  • 제24권4호
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  • Pages.243-252
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  • 2022
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  • 2383-6415(pISSN)
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  • 2383-6423(eISSN)
한국기초간호학회 (Korean society of Biological Nursing Science)
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간이식 환자의 퇴원 준비도와 자가간호와의 관계: 종단적 연구

Relationship between Readiness for Hospital Discharge and Self-care of Liver Transplant Recipients: A Single-center Prospective Study

  • 박선복 (버지니아 대학교 간호학과) ;
  • 최지연 (연세대학교 간호대학.김모임간호학연구소) ;
  • 주동진 (연세대학교 의과대학 외과학교실, 세브란스병원) ;
  • 추상희 (연세대학교 간호대학.김모임간호학연구소)
  • Park, SunBok (School of Nursing, University of Virginia) ;
  • Choi, JiYeon (Mo-Im Kim Nursing Research Institute.College of Nursing, Yonsei University) ;
  • Joo, DongJin (Department of Surgery, Yonsei University College of Medicine, Severance Hospital) ;
  • Chu, SangHui (Mo-Im Kim Nursing Research Institute.College of Nursing, Yonsei University)
  • 투고 : 2022.09.30
  • 심사 : 2022.11.24
  • 발행 : 2022.11.30
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초록

Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p=.027), with fewer post-transplantation days (p=.027), absence of acute rejection (p=.004), or high self-efficacy (p<.001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β=0.29, p<.001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion: Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.

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과제정보

본 연구는 서울시간호사회의 지원을 받아 작성되었음.

참고문헌

  1. Lee SG. Current status of liver transplantation in Korea. The Korean Journal of Gastroenterology. 2005;46(2):75-83.
  2. KONOS (Korean Network for Organ Sharing). Annual report of transplant, 2020. The National Institute of Organ, Tissue and Blood Management; 2022. p. 57.
  3. Serper M, Asrani S, Vanwagner L, Reese PP, Kim M, Wolf MS. Redefining success after liver transplantation: from mortality toward function and fulfillment. Liver Transplantation. 2022;28(2):304-313. http://doi.org/10.1002/lt.26325
  4. Santonicola A, Zingone F, Camera S, Siniscalchi M, Ciacci C. Telemedicine in the COVID-19 era for liver transplant recipients: an Italian lockdown area experience. Clinics and Research in Hepatology and Gastroenterology. 2021; 45(3):101508. https://doi.org/10.1016/j.clinre.2020.07.013
  5. Zhizhpon-Quinde TC, Mesa-Cano IC, Ramirez-Coronel AA. Prevention of COVID-19 through Dorothea Orem's self-care theory. International Journal of Innovative Science and Research Technology. 2021;6(3):809-815.
  6. Lin M, Mah A, Wright AJ. Infectious complications of liver transplantation. AME Medical Journal. 2018;3(1):1-14. http://doi.org/10.21037/amj.2017.12.10
  7. Fatourou EM, Tsochatzis EA. Management of metabolic syndrome and cardiovascular risk after liver transplantation. The Lancet Gastroenterology & Hepatology. 2019;4(9):731-741. https://doi.org/10.1016/S2468-1253(19)30181-5
  8. Kim H, Choi M, Kim SS, Kim S. Self-care, social support, and biological markers in liver transplant recipients. Korean Journal of Adult Nursing. 2015;27(2):170-179. https://doi.org/10.7475/kjan.2015.27.2.170
  9. Artru F, Louvet A, Mathurin P. Liver transplantation for patients with alcoholic hepatitis. Liver International. 2017;37(3):337-339. http://doi.org/10.1111/liv.13248
  10. Fleming MF, Smith MJ, Oslakovic E, Lucey MR, Vue JX, Al-Saden P, et al. Phosphatidylethanol detects moderate-to-heavy alcohol use in liver transplant recipients. Alcoholism: Clinical and Experimental Research. 2017;41(4):857-862. http://doi.org/10.1111/acer.13353
  11. Ko D, Muehrer RJ, Bratzke LC. Self-management in liver transplant recipients. Progress in Transplantation. 2018;28(2):100-115. http://doi.org/10.1177/1526924818765814
  12. Lee T, Kang I. Relationship between self-care awareness and performance in liver transplantation patients. Global Health & Nursing. 2016;6(2):51-58. https://doi.org/10.35144/ghn.2016.6.2.51
  13. Jung H, Kim Y. Impact of self-esteem and social support on self-care performance in liver transplantation recipients. Korean Journal of Rehabilitation Nursing. 2020:132-139. https://doi.org/10.7587/kjrehn.2020.132
  14. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychological Review. 1977;84(2):191-215. http://doi.org/10.1037/0033-295X.84.2.191
  15. Moon S, Kim H. Effects of self-efficacy and transplant-related knowledge on compliance with a therapeutic regimen for recipients of liver transplant. Journal of Korean Academy of Fundamentals of Nursing. 2019;26(3):166-175. https://doi.org/10.7739/jkafn.2019.26.3.166
  16. Kim SH, Lee YJ, Lee SY, Chu SH. Current interventions to improve adherence to immunosuppressants in liver transplant recipients: a systematic review. Journal of Korean Biological Nursing Science. 2016;18(1):17-26. https://doi.org/10.7586/jkbns.2016.18.1.17
  17. Li AH, Lam NN, Naylor KL, Garg AX, Knoll GA, Kim SJ. Early hospital readmissions after transplantation: burden, causes, and consequences. Transplantation. 2016;100(4):713-718. http://doi.org/10.1097/tp.0000000000000917
  18. Paterno F, Wilson GC, Wima K, Quillin RC, Abbott DE, Cuffy MC, et al. Hospital utilization and consequences of readmissions after liver transplantation. Surgery. 2014;156(4):871-878. http://doi.org/10.1016/j.surg.2014.06.018
  19. Yataco M, Cowell A, David W, Keaveny AP, Taner CB, Patel T. Predictors and impacts of hospital readmissions following liver transplantation. Annals of Hepatology. 2016;15(3):356-362. http://doi.org/10.5604/16652681.1198805
  20. Weiss ME, Piacentine LB. Psychometric properties of the readiness for hospital discharge scale. Journal of Nursing Measurement. 2006;14(3):163-180. http://doi.org/10.1891/jnm-v14i3a002
  21. Titler MG, Pettit DM. Discharge readiness assessment. The Journal of cardiovascular nursing. 1995;9(4):64-74. http://doi.org/10.1097/00005082-199507000-00007
  22. Weiss ME, Piacentine LB, Lokken L, Ancona J, Archer J, Gresser S, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clinical Nurse Specialist. 2007;21(1):31-42. http://doi.org/10.1097/00002800-200701000-00008
  23. Henderson A, Zernike W. A study of the impact of discharge information for surgical patients. Journal of Advanced Nursing. 2001;35(3):435-441. http://doi.org/10.1046/j.1365-2648.2001.01857.x
  24. Kwon H. Structural equation modeling of readiness for hospital discharge by family caregivers of patients transferred [dissertation]. Seoul: Seoul National University; 2017. p.19-71.
  25. Lerret SM, Weiss ME, Stendahl GL, Chapman S, Menendez J, Williams L, et al. Pediatric solid organ transplant recipients: transition to home and chronic illness care. Pediatric Transplantation. 2015;19(1):118-129. http://doi.org/10.1111/petr.12397
  26. Wallace AS, Perkhounkova Y, Bohr NL, Chung SJ. Readiness for hospital discharge, health literacy, and social living status. Clinical Nursing Research. 2016;25(5):494-511. http://doi.org/10.1177/1054773815624380
  27. Meng N, Liu R, Wong M, Liao J, Feng C, Li X. The association between patient-reported readiness for hospital discharge and outcomes in patients diagnosed with anxiety disorders: a prospective and observational study. Journal of Psychiatric and Mental Health Nursing. 2020;27(4):380-392. http://doi.org/10.1111/jpm.12592
  28. Monfared A, Dehghan Nayeri N, Javadi-Pashaki N, Jafaraghaee F. Readiness for discharge from hospital: a concept analysis. Qualitative Research Journal. 2022;22(3):415-432. http://doi.org/10.1108/QRJ-02-2022-0022
  29. Yoon J. The effect of discharge education on the self care performance for liver transplantation patients [master's thesis]. Seoul: Seoul National University; 2007. p.78-79.
  30. Ahn JH. The Effect of the self efficacy promotion and exercise training program of kidney transplant recipients. Journal of Korean Academy of Nursing. 2000;30(5):1181-1194. https://doi.org/10.4040/jkan.2000.30.5.1181
  31. Sharma P, Kumar A, Anikhindi S, Bansal N, Singla V, Shivam K, et al. Effect of COVID-19 on pre-existing liver disease: what hepatologist should know? Journal of Clinical Experimental Hepatology. 2021;11(4):484-493. http://doi.org/10.1016/j.jceh.2020.12.006
  32. Aiello FI, Bajo M, Marti F, Gadano A, Musso CG. Model for end-stage liver disease (MELD) score and liver transplant: benefits and concerns. AME Medical Journal. 2017;2(11):168. http://doi.org/10.21037/amj.2017.10.10
  33. Jeon M, Park Y. Structural equation modeling of self-management of liver transplant recipients. Journal of Korean Academy of Nursing. 2017;47(5):663-675. http://doi.org/10.4040/jkan.2017.47.5.663
  34. Gumidyala AP, Greenley RN, Plevinsky JM, Poulopoulos N, Cabrera J, Lerner D, et al. Moving on: transition readiness in adolescents and young adults with IBD. Inflammatory Bowel Disease. 2018;24(3):482-489. http://doi.org/10.1093/ibd/izx051
  35. Pinero F, Fauda M, Quiros R, Mendizabal M, Gonzalez-Campana A, Czerwonko D, et al. Predicting early discharge from hospital after liver transplantation (ERDALT) at a single center: a new model. Annals of Hepatology. 2015;14(6):845-855. http://doi.org/10.5604/16652681.1171770
  36. Spillman LN, Melville-Claxton A, Gatiss GA, Fernandez N, Madden AM. Diet and physical activity after liver transplant: a qualitative study of barriers and facilitators to following advice. Journal of Human Nutrition and Dietectics. 2021;34(5):910-919. http://doi.org/10.1111/jhn.12874
  37. Neuberger J. Follow-up of liver transplant recipients. Best Practice & Research Clinical Gastroenterology. 2020;46-47:101682. https://doi.org/10.1016/j.bpg.2020.101682
  38. Lieber SR, Kim HP, Baldelli L, Nash R, Teal R, Magee G, et al. What survivorship means to liver transplant recipients: qualitative groundwork for a survivorship conceptual model. Liver Transplatation. 2021;27(10):1454-1467. http://doi.org/10.1002/lt.26088
  39. Kothari AN, Yau RM, Blackwell RH, Schaidle-Blackburn C, Markossian T, Zapf MA, et al. Inpatient rehabilitation after liver transplantation decreases risk and severity of 30-day readmissions. Journal of American College of Surgeon. 2016;223(1):164-171. http://doi.org/10.1016/j.jamcollsurg.2016.01.061
  40. Zeidan JH, Levi DM, Pierce R, Russo MW. Strategies that reduce 90-day readmissions and inpatient costs after liver transplantation. Liver Transplantation. 2018;24(11):1561-1569. http://doi.org/10.1002/lt.25186
  41. Taher M, Toossi MN, Jafarian A, Rasti A, Nayeri ND. Patients' experiences of life challenges after liver transplantation: a qualitative study. Journal of Patient Experience. 2021;8:2374373521996956. http://doi.org/10.1177/2374373521996956