Title Page
Abstract
Contents
List of Abbreviations 15
Ⅰ. Introduction 17
1. Background 17
2. Purpose of Research 20
3. Terminology 21
1) Living liver donor 21
2) Unmet expectation 21
3) Health-related quality of life 22
Ⅱ. Literature Review 23
1. Living Donor Liver Transplant 23
2. Preoperative Effort to Advocate Living Liver Donors 25
1) A legal perspective 25
2) A medical perspective 26
3) A psychosocial perspective 27
4) An ethical perspective 27
3. Postoperative Outcomes and Patient Expectations 29
4. Health-related Quality of Life in Living Liver Donors 31
Ⅲ. Theoretical Framework 34
Ⅳ. Methods 41
1. Study Design 41
2. Study Participants and Setting 41
3. Instruments 42
1) Health-related quality of life 42
2) Unmet expectations about surgical outcomes 43
3) Confounding variables 43
4. Ethical Considerations 45
5. Data Collection 45
6. Data Analysis 46
Ⅴ. Results 50
1. Sample Description 50
1) Demographic and donor-specific characteristics 50
2) Surgical complications 53
2. Unmet Expectations about Surgical Outcomes 56
3. Health-related Quality of Life 62
1) Comparison of two-component summary scores 62
2) Comparison of eight domain scores 64
4. Logistic Regression Models 68
1) Logistic regression model for physical well-being 68
2) Logistic regression model for mental well-being 71
Ⅵ. Discussion 74
1. Unmet Expectations about Surgical Outcomes 74
2. Health-related Quality of Life and Its Predictors 76
3. Fulfillment of Expectations and Information 78
4. Nursing Implications 81
1) Nursing research 81
2) Nursing practice 82
5. Limitations 83
Ⅶ. Conclusion and Recommendations 85
1. Conclusion 85
2. Recommendations 86
References 89
Appendices 14
Appendix 1. The approval by an institutional review board. 105
Appendix 2. Recruitment notices for study participants. 108
Appendix 3. Participant informed consent forms. 110
Appendix 4. Quality metric incorporated, license agreement. 114
Appendix 5. The questionnaire (excluding a paid questionnaire-III SF-12) 123
국문 초록 126
Table 1. Characteristics of the living liver donors (N=124) 51
Table 2. Postoperative complications 54
Table 3. Frequencies of the four items of postoperative experience in comparison with preoperative expectations (n=124) 57
Table 4. Associations between unmet expectations about the length of hospital stay and time since donation (n = 124) 58
Table 5. Associations between unmet expectations about the speed of recovery and time since donation (n = 124) 59
Table 6. Associations between unmet expectations about pain and time since donation (n = 124) 60
Table 7. Associations between unmet expectations about complications and time since donation (n = 124) 61
Table 8. Mean scores of eight domains of SF-12v2 by sex and age groups 65
Table 9. Logistic regression model for poor PCS scores (N=124) 69
Table 10. Logistic regression model for poor MCS scores (N=124) 72
Figure 1. Expectations model by Calman (1984) 37
Figure 2. Theoretical framework 40
Figure 3. SF-12v2 component summary mean scores in LLDs and general Korean population by time since donation 63
Figure 4. Mean scores of eight domains of SF-12v2 by sex 66
Figure 5. Mean scores of eight domains of SF-12v2 by age groups 67