title: The influence of alcohol abuse history on the differential, longitudinal patterns of mental and physical quality of life following liver transplantation.
abstract: This prospective, longitudinal study investigated change in physical and mental health quality of life (QoL) in a sample of 65 end-stage liver disease patients before and after liver transplantation. Physical and mental health QoL were assessed using the SF-36 Physical Health Summary and Mental Health Summary, respectively. Baseline data were collected prior to transplant and follow-up data were collected at 1 and 6 months after transplantation. Repeated-measures analysis of variance results indicate that physical QoL did not improve significantly between baseline and 1-month follow-up (F = .031, P = .860) but did between 1- and 6-month follow-up (F = 20.873, P < .001). Significant between-subject effects suggested attenuated improvement for patients with alcohol abuse histories (F = 6.213, P = .017). Physical QoL did not improve between 1- and 6-month follow-up for patients with alcohol abuse history (t((13)) = -1.074, P = .112). By contrast, mental health QoL improved significantly between baseline and 1-month follow-up (F = 13.840, P < .001), but not between 1- and 6-month follow-up (F = .750, P = .391). No significant differences were found on the Mental Health Summary index based on alcohol abuse history for either time period. Post hoc multivariate analysis of variance results suggested worse functioning (F = 2.674, P = .013) for individuals with alcohol abuse history on SF-36 Physical Functioning (F = 5.55, P = .021), Body Pain (F = 13.578, P < .001), Vitality (F = 4.337, P = .040), and Social Functioning (F = 10.50, P = .002) subscales. For liver transplant patients, improvements in psychosocial functioning and QoL precede improvements in physical QoL. Attenuated physical QoL improvements for patients with alcohol abuse histories are related to greater pain and physical deficits.
authors.affiliation: Department of Behavioral Health, Henry Ford Health System, Detroit, Michigan 48202, USA.
authors.forename: A
authors.initials: A
authors.lastname: Eshelman
authors.forename: D
authors.initials: D
authors.lastname: Paulson
authors.forename: T
authors.initials: T
authors.lastname: Meyer
authors.forename: D
authors.initials: D
authors.lastname: Fischer
authors.forename: D
authors.initials: D
authors.lastname: Moonka
authors.forename: K
authors.initials: K
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Abouljoud
mesh_terms: D000437:Alcoholism / Q000503:physiopathology / Q000523:psychology; D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D016031:Liver Transplantation; D011788:Quality of Life