Symptoms and Distress Among Patients With Liver Cirrhosis but Without Hepatocellular Carcinoma in Taiwan

A cross-sectional study design was used to assess the items and frequency of physical symptoms and psychological distress among patients with liver cirrhosis (LC) but without hepatocellular carcinoma. Inpatients with LC were recruited from a medical center in northern Taiwan. Informants were asked to describe their frequency of symptoms and distress at 2 weeks before admission. During August 2008 and July 2009, 49 patients participated. The symptoms and distress were moderate, with a mean of 3.9 and 4.2 of 7, respectively. The mean ranking of subscales from the highest to lowest was abdominal symptoms, fatigue, fluid retention, loss of appetite, systemic symptoms, decreased attention, and bleeding. Symptoms and distress were significantly correlated (r = .59). The total scores of symptoms and distress were not associated with causes of the disease (p = .7644, p = .8548, respectively), disease severity (p = .7203, p = .3354, respectively), disease duration (p = .5820, p = .8184, respectively), or previous admission (p = .3094, p = .7365, respectively), but decreased attention was significantly associated with disease severity (p = .0317) and systemic symptoms were significantly associated with disease duration (p = .0267). The study found that physical symptoms and psychological distress are multidimensional and highly correlated. Our findings can be used to develop a symptom management program to relieve discomfort and indirectly improve the quality of life for individuals with LC.

[1]  M. Clayton,et al.  Liver disease in women: Examining prevalence and complications , 2010 .

[2]  Yi-Jang Lee,et al.  Association between MDM2-SNP309 and hepatocellular carcinoma in Taiwanese population. , 2009, World journal of gastroenterology.

[3]  D. Skene,et al.  Sleep-wake patterns in patients with cirrhosis: all you need to know on a single sheet. A simple sleep questionnaire for clinical use. , 2009, Journal of hepatology.

[4]  N. Toshikuni,et al.  Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus‐related cirrhosis , 2009, Journal of gastroenterology and hepatology.

[5]  K. Rothstein,et al.  Health maintenance issues in cirrhosis. , 2009, The Medical clinics of North America.

[6]  J. Hammer,et al.  Gastrointestinal symptoms in patients with liver cirrhosis are linked to impaired quality of life and psychological distress , 2009, European journal of gastroenterology & hepatology.

[7]  D. Nåden,et al.  Patients' experiences of waiting for a liver transplantation. , 2008, Nursing inquiry.

[8]  F. Cirignotta,et al.  Sleep disturbance and daytime sleepiness in patients with cirrhosis: a case control study , 2008, Neurological Sciences.

[9]  A. Burroughs,et al.  Muscle cramps in cirrhosis: the therapeutic value of quinine. Is it underused? , 2008, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[10]  Chien-Jen Chen,et al.  Associations Between Hepatitis B Virus Genotype and Mutants and the Risk of Hepatocellular Carcinoma , 2008, Journal of the National Cancer Institute.

[11]  Katy Sutcliffe,et al.  An integrated care pathway improves quality of life in Primary Biliary Cirrhosis. , 2008, QJM : monthly journal of the Association of Physicians.

[12]  J. Bajaj Minimal hepatic encephalopathy matters in daily life. , 2008, World journal of gastroenterology.

[13]  A. Grippo,et al.  Fatigue in primary biliary cirrhosis: a possible role of comorbidities , 2008, European journal of gastroenterology & hepatology.

[14]  M. Yuen,et al.  The Natural History and Treatment of Chronic Hepatitis B: A Critical Evaluation of Standard Treatment Criteria and End Points , 2007, Annals of Internal Medicine.

[15]  M. Freeston,et al.  The role of psychological factors in the fatigue of primary biliary cirrhosis , 2007, Liver international : official journal of the International Association for the Study of the Liver.

[16]  Z. Younossi,et al.  Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection , 2007, Digestive Diseases and Sciences.

[17]  J. Annoni,et al.  Histamine H1 Blocker Hydroxyzine Improves Sleep in Patients With Cirrhosis and Minimal Hepatic Encephalopathy: A Randomized Controlled Pilot Trial , 2007, The American Journal of Gastroenterology.

[18]  L. Kupčinskas,et al.  Disease-specific health-related quality of life and its determinants in liver cirrhosis patients in Lithuania. , 2006, World journal of gastroenterology.

[19]  S. Sargent Management of patients with advanced liver cirrhosis. , 2006, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[20]  Soo Hyun Kim,et al.  Symptom experience, psychological distress, and quality of life in Korean patients with liver cirrhosis: a cross-sectional survey. , 2006, International journal of nursing studies.

[21]  B. Bell,et al.  The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. , 2006, Journal of hepatology.

[22]  Roberta Jorgensen,et al.  A phenomenological study of fatigue in patients with primary biliary cirrhosis. , 2006, Journal of advanced nursing.

[23]  J. Newton,et al.  Fatigue in primary biliary cirrhosis is associated with excessive daytime somnolence , 2006, Hepatology.

[24]  Soo Hyun Kim,et al.  Symptom experience in Korean patients with liver cirrhosis. , 2006, Journal of pain and symptom management.

[25]  T. Luedde,et al.  Clinical and prognostic role of plasma coagulation factor XIII activity for bleeding disorders and 6‐year survival in patients with chronic liver disease , 2006, Liver international : official journal of the International Association for the Study of the Liver.

[26]  G. Dalekos,et al.  Sleep apnoea syndrome and early stage cirrhosis: a pilot study , 2006, European journal of gastroenterology & hepatology.

[27]  E. Björnsson,et al.  Gastrointestinal symptoms in patients with liver cirrhosis: Associations with nutritional status and health-related quality of life , 2006, Scandinavian journal of gastroenterology.

[28]  G. Marchesini,et al.  Psychological status and depression in patients with liver cirrhosis. , 2005, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[29]  M. Başkol,et al.  The Role of Serum Zinc And Other Factors on the Prevalence of Muscle Cramps in Non-alcoholic Cirrhotic Patients , 2004, Journal of clinical gastroenterology.

[30]  M. Bass Fluid and electrolyte management of ascites in patients with cirrhosis. , 1998, Critical Care Nursing Clinics of North America.

[31]  P. Penev,et al.  High prevalence of sleep disturbance in cirrhosis , 1998, Hepatology.

[32]  P. Angeli,et al.  Cirrhosis and muscle cramps: Evidence of a causal relationship , 1996, Hepatology.

[33]  A. Blei,et al.  Disruption of the Diurnal Rhythm of Plasma Melatonin in Cirrhosis , 1995, Annals of Internal Medicine.

[34]  R. Pugh,et al.  Transection of the oesophagus for bleeding oesophageal varices , 1973, The British journal of surgery.

[35]  N. Bergasa,et al.  Itch in primary biliary cirrhosis: a patients' perspective. , 2008, Acta dermato-venereologica.

[36]  G. Marchesini,et al.  Factors associated with poor health-related quality of life of patients with cirrhosis. , 2001, Gastroenterology.