City Research Online

Working with chronic illness: the application of health psychology in renal and liver transplant services

Wong, D. M-W. (2017). Working with chronic illness: the application of health psychology in renal and liver transplant services. (Unpublished Doctoral thesis, City, University of London)

Abstract

Background: Liver disease is one of the top ten causes of death in the U.K . With an increase of 12% between 2005-2008 (British Liver Trust, 2008), liver transplantation has become the treatment of choice for liver disease. Due to improved effectiveness of medication and advancement of surgical techniques, clinical outcomes for liver transplant have continued to improve. Focus has turned to quality of life and how effectively a patient post-transplant can return to routines of daily living (Rainer, Thompson & Lammbros, 2010).

A small number of qualitative studies have explored the experiences of adults following liver transplantation in the nursing literature. Studies previously carried out have mainly emphasised physical and medical issues such as adherence, side effects, infection, death and dying. Whereas other research has emphasised the transplant recipients’ functionality and ability to perform everyday tasks and fulfil social roles. Past investigations into liver transplant have been measured by the absence of medical complaints, however, questioning how individuals struggle do not always reflect how patients who have experienced a transplant have adapted throughout the recovery period.

Aims: The present study aims to explore the experience of patients who have experienced a liver transplant and how they have adapted throughout the recovery period. The study intends to develop a theoretical model which can inform targeted psychological treatment to encourage and optimise patient recovery following transplantation.

Methodology: Data was collected via semi-structured one to one interviews, from a sample of liver transplant recipients via routine follow-up clinics. A modified grounded theory approach (Corbin & Strauss, 1998) was used as the main method of gathering synthesizing and conceptualising the data, supported by the use of Computer-Assisted Qualitative Data Analysis Software (CAQDAS) to facilitate the grounded theory process.

Findings: A total of 11 transplant recipients consented to be interviewed providing a unique insight into the experiences of liver transplant and post-surgical recovery. Findings are explored in stages; 1. Exploring the phenomenon of having a liver transplant; 2. Protective Factors; and finally, 3. The core concept of Resilience. Findings indicated a number of concepts, demonstrating the journey for liver transplant recipients from diagnosis through to the ongoing recovery period. Participants demonstrated multiple strengths and protective coping mechanisms helping them through each phase of ‘disruption’ and the use of narrative to re-organise, formulate and make meaning of their experiences. Data collected through interviews provided overwhelming evidence for protective factors rooted within the core concept of resilience.

Conclusion: Evidence from the study and current research on resilience suggests that future interventions may need to focus less on risk amelioration and instead develop resources to enhance protective coping early on, impacting future resiliency.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine
Departments: Doctoral Theses
School of Health Sciences
URI: http://openaccess.city.ac.uk/id/eprint/22004
[img]
Preview
Text - Accepted Version
Download (9MB) | Preview

Export

Downloads

Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login