The construct of adjustment may help to understand the demands of end-stage liver failure (ESLF) and liver transplantation. Adjustment can be operationally defined on the basis of whether or not recipients and donors suffer from psychological problems and the ways in which they perceive their quality of life. For recipients of a transplant, evidence suggests that ESLF is related to the experience of psychological problems and poor quality of life, whereas transplantation is associated with less psychological problems and improvement in quality of life. Among donors, there is some evidence to suggest that organ donation surgery is associated with deterioration in quality of life and high levels of psychological problems. However, findings have been contradictory regarding the extent of these difficulties. Attempts to predict these outcomes are limited. More research is therefore needed. The construct of beliefs in general and the self-regulatory model of illness and qualitative research in particular could guide future attempts to explain these outcomes. Qualitative findings suggest that recipients and their donors experience ESLF and/or transplantation surgery or organ donation surgery in ways that are not identified by quantitative research. These findings can be used not only to develop ESLF-specific quality of life or emotional well-being questionnaires but also patient- or donor-derived interventions to improve poor outcomes.
Part of the book: Liver Research and Clinical Management