الفهرس 
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Abstract
Summary
Liver transplantation is considered one of the most complex procedures in modern surgery. Its success depends on a complete hospital infrastructure, in addition to a multidisciplinary team skilled to care for severely debilitated and immunosuppressed patients (McCormack et al, 2011).
The goal of transplantation is not only to ensure a patient’s survival, but also to offer the patient the same state of health that he or she enjoyed before the disease and achieve a balance between the functional efficacy of the graft and the patient’s psychological and physical integrity. (Bravata et al, 2019)
Nurses are responsible for the planning and implementation of care delivered to patients and families during the liver transplantation process. Apart from giving direct care, Nurses perform learning activities for patients and their relatives concerning long-term measures to ensure and thereby promote health. (Masih & Sharma, 2019)
The patient’s understanding of physical condition will lead to the development of self-care. In the case of patients who need a solid organ transplant, the need for an educational process becomes even more relevant. In this case, the patient needs to learn how to administer the new medication that he will use for the rest of his life, in addition to adhering to changes in lifestyle, such as hygiene practices, monitoring the new organ, preventing infection and social and professional readjustment. (Wright et al., 2017)
Although there have been increased developments in liver transplant and post-transplant care processes, one of the conditions that affect transplant and post-transplant process is the individual’s illness perception. Illness perception refers to thoughts, ideas, and beliefs about illness during the illness period and the following recovery period, and it constitutes individuals’ behaviors and coping mechanisms. (Kapikiran et al, 2021)
Aim of the study:
The aim of this study was to assess needs and perception for patients undergoing liver transplant.
Research Questions:
What are needs of patients undergoing liver transplantation?
What are perception of patients undergoing liver transplantation?
A purposive sample of (30) patients with end stage chronic liver disease undergoing liver transplant were included in this study.
Tools for data collection
Tool (I):
Part (1): Structured interview questionnaire comprises one part related to
a) Demographic data: It includes (age, gender, marital status, residence, level of education and occupation).
b) Medical history of the patients: It is used to assess the present medical history of the patients and family history of the same disease.
It has been developed in simple Arabic language based in extensive review of relevant and recent literatures.
Part (2): Needs assessment questionnaire: This part was developed by the researcher based on national and international literature review to assess the needs of patients undergoing to liver transplant.
Tool (II):
Treatment Effects Questionnaire (TEQ): to assess patients’ perceptions of the consequences associated with their current treatment adapted from Griva, Jayasena, Davenport, Harrison, and Newman, (2009). Consists of 20 items.
Items were scored on an 8-point scale ranging from 0 to 7.
Results:
70% of the studied patients were with age group more than 40 years and 93% of them were married. In relation to educational level, 80% of patients had secondary school education, 73.3% of patients had professions requiring physical strength, and 83.3% of them had insufficient income of their own.
53.3% of the studied patients had family history of liver disease, 87.5% of their liver diseased family members had liver cirrhosis
according to the neurological system, 100% of patients suffered from distractibility and imbalance, and 76.7% of patients suffered from low concentration preoperatively
100% of the studied patients had nausea, vomiting, heart burn, bloating, 60% of patients has ascites, and 53.3% of them had hematemesis preoperatively, and 100% of them had nausea, vomiting, 53.3% suffered from heart burn, 33.3% suffered from bloating, 3.3% of patients has ascites and hematemesis postoperatively.
According to the Elimination system 73.3% suffered from constipation, 66.7% of the studied patients suffered from polyuria, 56.7% of patients suffered from change in their urine color preoperatively, while 66.7% suffered from constipation, 66.7% of the studied patients suffered from polyuria, 10.0% of patients suffered from change in their urine color postoperatively.
The disease affected on sexual desire and relation with partner in 93.3% of the studied patients (married patients) preoperatively, and 100% of them didn’t know when to resume sexual activity.
100% of studied patients were afraid of disease progression, 90% were worry about the surgical intervention, 86.7% became easily annoyed, sometimes crying, feel low self-esteem and were not coping with the new situation of the disease, however, through the postoperative period 93.3% of patients reported that operation improved their general health, and only 6.7% felt worry and low self-esteem.
100% of studied patients the disease interfered with their jobs, social activities, finance, and they all had emotional support from their families.
93.3% of studied patients needed to know about postoperative pain management, 86.7% needed to know how to do postoperative exercise, and 46.7% of needed to know the hospital-stay period.
There was a highly statistically significant difference between patients’ age regarding their psychological and physiological needs domains (F= 11.017 &3.942 respectively) with P<0.01 as psychological needs are high in (>40) years age group and physiological needs are high in (30-40) years age group than other age groups. there was no significant difference between patients’ age groups regarding their as social and learning needs.
The highest patients’ needs were the psychological needs (87.3%) followed by social needs (71.5%) and physiological needs (48.2%) while learning needs were at lowest (36%).
As regard to total mean of perception, the current study results revealed that less than two third of the studied patients were disagree positively.
There is no statistically significant difference between patients’ sociodemographic data and their perception.
Conclusion:
In the light of the current study findings, it can be concluded that
The majority of the studied patients had psychological needs followed by less than three quarters of them had social needs and less than half of them had physiological needs while more than one third had learning needs.
Regarding patients’ perception, less than two thirds of the studied patients had positive perception regarding toward treatment after liver transplantation.
Recommendations:
Based on the current study finding the following recommendations were proposed:
Learning guidelines should be provided for patients undergoing liver transplantation start from admission until discharge from the hospital.
A simple booklet should be provided for patients undergoing liver transplantation needs including all aspects such as medications, nutrition, daily activity, follow-up and early warning signs of infection and its prevention which may be a guide and reference to them.
A comprehensive and simplified booklet including the therapeutic regimen which submitted to the liver transplant patients after admission to the hospital will serve as a care guide and reference to the patients and their families according to their needs.