title: Liver transplant recipients quality of life instrument: development and psychometric testing.
abstract: BACKGROUND
  Liver transplantation is a life-saving intervention for many patients with end-stage liver disease. In the past, evaluation of successful liver transplantation was based on patients' survival rate. However, in recent years this evaluation has been based on patients' quality of life. Various instruments have been developed to evaluate patients' quality of life. Nonetheless, scholars still believe that it is crucial to develop a standardized and disease specific instrument for evaluating the quality of life in liver transplant recipients.
  
  
  OBJECTIVE
  The aim of this paper was to describe the development and psychometric testing process of a quality of life instrument specific to liver transplant recipients.
  
  
  METHODS
  Initial items of this instrument were extracted from a conventional content analysis study, and then were completed with findings of related international literature. The face validity was assessed by interviewing with four liver transplant recipients, and the content validity was evaluated by eleven experts in the field of transplantation. The construct validity was achieved by involving 250 liver transplant recipients through exploratory factor analysis method, and reliability was calculated by Cronbach's alpha.
  
  
  RESULTS
  Three main factors with 40 items were extracted from the exploratory factor analysis: Health Satisfaction, Concerns, and Complications. Reliability of the instrument was confirmed (alpha = 0.922).
  
  
  CONCLUSIONS
  Given the special considerations regarding liver transplant recipients, this questionnaire is more accurate in evaluating the success of liver transplantation.
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Parsa Yekta
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Tayebi
authors.affiliation: Department of Nursing and Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hooman
authors.initials: H
authors.lastname: Shahsavari
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Ebadi
authors.affiliation: Depatment of Educational Psychology, Faculty of Psychology, Kharazmi University, Karaj, IR Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Tayebi
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Bolourchifard
authors.affiliation: Centre of Nursing Care Research, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Forough
authors.initials: F
authors.lastname: Rafii
keywords: Liver Transplantation; Quality of Life; Questionnaire