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What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model.

Publication ,  Journal Article
Lieber, SR; Kim, HP; Baldelli, L; Nash, R; Teal, R; Magee, G; Loiselle, MM; Desai, CS; Lee, SC; Singal, AG; Marrero, JA; Barritt, AS; Evon, DM
Published in: Liver Transpl
October 2021

Survivorship is a well-established concept in the cancer care continuum with a focus on disease recurrence, quality of life, and the minimization of competing risks for mortality; however, survivorship has not been well studied in liver transplantation (LT). We investigated what survivorship means to LT patients and identified motivations and coping strategies for overcoming challenges after LT. A total of 20 in-depth home interviews were conducted among adults 3 to 6 months after LT. Interviews were conducted by trained qualitative research experts and coded and analyzed using an inductive approach. A majority of LT recipients (75%) identified themselves as survivors. Integral to the definition of survivorship was overcoming hardship (including experiences on the waiting list) and the unique experience of being given a "second chance" at life. Motivations to survive included a new chance at life (55%), family (40%), spirituality/faith (30%), and fear of rejection (15%). LT recipients and caregivers identified multiple strategies to cope with post-LT challenges, including relying on a large network of community, spiritual, and virtual support. These findings informed a conceptual model of LT survivorship based on socioecological theory, which identified the following variables influencing survivorship: (1) pretransplant experiences, (2) individual attributes and challenges, (3) interpersonal relationships with caregivers and other social support, (4) community relationships, and (5) large-scale factors including neighborhood and financial issues. LT recipients identified themselves as survivors, and post-LT identities were greatly influenced by pre-LT experiences. These perspectives informed an in-depth conceptual model of survivorship after transplantation. We identified sources of motivation and coping strategies used in LT recovery that could be targets of survivorship interventions aimed at improving post-LT outcomes.

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Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

October 2021

Volume

27

Issue

10

Start / End Page

1454 / 1467

Location

United States

Related Subject Headings

  • Transplant Recipients
  • Survivorship
  • Survivors
  • Surgery
  • Quality of Life
  • Qualitative Research
  • Liver Transplantation
  • Humans
  • Adult
  • Adaptation, Psychological
 

Citation

APA
Chicago
ICMJE
MLA
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Lieber, S. R., Kim, H. P., Baldelli, L., Nash, R., Teal, R., Magee, G., … Evon, D. M. (2021). What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model. Liver Transpl, 27(10), 1454–1467. https://doi.org/10.1002/lt.26088
Lieber, Sarah R., Hannah P. Kim, Luke Baldelli, Rebekah Nash, Randall Teal, Gabrielle Magee, Marci M. Loiselle, et al. “What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model.Liver Transpl 27, no. 10 (October 2021): 1454–67. https://doi.org/10.1002/lt.26088.
Lieber SR, Kim HP, Baldelli L, Nash R, Teal R, Magee G, et al. What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model. Liver Transpl. 2021 Oct;27(10):1454–67.
Lieber, Sarah R., et al. “What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model.Liver Transpl, vol. 27, no. 10, Oct. 2021, pp. 1454–67. Pubmed, doi:10.1002/lt.26088.
Lieber SR, Kim HP, Baldelli L, Nash R, Teal R, Magee G, Loiselle MM, Desai CS, Lee SC, Singal AG, Marrero JA, Barritt AS, Evon DM. What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model. Liver Transpl. 2021 Oct;27(10):1454–1467.
Journal cover image

Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

October 2021

Volume

27

Issue

10

Start / End Page

1454 / 1467

Location

United States

Related Subject Headings

  • Transplant Recipients
  • Survivorship
  • Survivors
  • Surgery
  • Quality of Life
  • Qualitative Research
  • Liver Transplantation
  • Humans
  • Adult
  • Adaptation, Psychological