Symptom experience, psychological distress, and quality of life in Korean patients with liver cirrhosis: A cross-sectional survey

Abstract

Background In patients with cirrhosis, quality of life (QOL) is seriously impaired and associated with particular symptoms such as fatigue, muscle cramps or pruritus. However, there is lack of evidence about the overall symptom experience in patients with cirrhosis, in addition, most studies on QOL have focused only on identifying the relationship between disease-related variables such as disease severity, etiology or serological markers and QOL. Objectives This study aimed to describe symptom experience, psychological distress, and QOL in Korean patients with liver cirrhosis, and to identify the factors that predict their quality of life. Design This study is a cross-sectional, descriptive design. Settings The participants were recruited over a 2-month period, September 27 to November 25, 2003 from the outpatient or inpatient departments of gastroenterology at two large university hospitals in Seoul, Korea. Participants There were 129 patients, mean age was 53.6 years, who met eligibility criteria and agreed to participate in the study. Methods Symptom experience was measured with a scale developed by the researchers through a literature review on liver cirrhosis. Psychological distress was measured with the anxiety/depression category from the modified Korean version of the profile of mood states (POMS) [Shin, 1996. A study on verification of the profile of mood states (POMS) for Korean elders. Journal of Korean Academic Nursing 26, 743–758], and QOL was measured with quality of life index (QLI) developed by Ferrans and Powers [1985, Quality of life index: development and psychometric properties. Advances in Nursing Science 8, 15–24. www.uic.edu.orgs/qli]. Results The results indicated that (1) overall symptom experience score was relatively low, major symptoms needing a management were fatigue, ascites and/or edema, and muscle cramps; (2) the mean score of psychological distress revealed mild to moderate levels of anxiety and depression; (3) quality of life was found to be seriously impaired; (4) psychological distress, employment status, and symptom experience were significant predictors of QOL, and explained 29.8% of the total variance. Conclusion These results indicate that symptom management, which includes attention to associated psychological intervention, is imperative for improvement in the QOL in Korean patients with liver cirrhosis.