Leaving the experts: Experiences of liver transplant recipients in New Zealand

Abstract
Liver transplantation has been available in New Zealand since 1998 for people with acute or chronic liver failure, or primary liver cancer. While an interest in quality of life or health-related quality of life is evident in clinical paradigms and literature, research by recipients or inclusive of a recipient’s voice or perspective is limited across transplantation, especially in the area of liver transplantation. The aim of this study was to explore the experiences of liver transplant recipients leaving the experts in hospital and returning to their own homes. The study adopted a sequential, exploratory mixed-method design, with a qualitative part (in-depth interviews) with 17 liver transplant recipients to explore their perspectives on quality of life post-operation in order to develop key concepts of post-operative wellbeing. Sequentially, based on the key concepts developed in the qualitative part, a cross-sectional survey was developed and a cohort of 49 liver transplant recipients participated in the survey research as a form of triangulation. Participants for both phases were recruited by the New Zealand Liver Transplant Unit at Auckland City Hospital from their patient database. Results indicated an apparent gender difference in post-transplantation recovery, in that women indicated more anxiety than men at leaving the experts and returning home. Those recipients who were transitioned through Transplant House appeared more confident about returning home than those returning directly home from the New Zealand Liver Transplant Unit. Integral to successful recovery, post-transplantation relies on the role that nurses fulfil in facilitating effective clinical pathways that include timely patient education from pre-admission through to discharge and into the community.

Ngā ariā matua

Mai i te tau 1998 kua āhei te hunga o Aotearoa kua tino hē nei te ate, kua pāngia rānei e te mate pukupuku taketake o te ate, kia whakawhitia he ate hou ki ō rātou tinana. Ahakoa e kitea ana te aronui ki te pai o te noho o te tangata, me te kounga ora e pā ana ki te hauora i roto i ngā momo mahi tiaki tūroro me ōna pukapuka, kāore e tino kitea he rangahau nā te hunga whiwhi whēkau whakawhiti i kawe, otirā mō te whakawhiti ate, he torutoru noa ngā rangahau pērā. Te whāinga matua ia o tēnei rangahau he tūhura i ngā wheako o te hunga whiwhi ate hou, i muri i te wehenga atu i ngā tautōhito i te hohipera, me te hokinga atu ki te kāinga. I whāia tētahi huarahi tikanga maha, āta whakatepe, wherawhera kōrero hoki, me tētahi wāhi whakawhānui i te wāhanga ki ngā wheako (he uiuinga hōhonu) ki ētahi tangata whiwhi whakawhitinga ate 17, hei tūhura i ō rātou whakaaro mō te kounga o te noho i muri i te pokanga hei whakawhānui i ētahi tino ariā o te ora i muri i te pokanga tinana. I runga i tētahi tāhuhu mahi i āta whakaritea, ka whakawhanaketia tētahi tirohanga whakapae, ā, ka uru atu tētahi tira tangata whiwhi ate hou 49 ki ngā rangahau tirohanga, hei momo pou tuatoru mō te mahi. Ko te hunga whai wāhi mō ngā wāhanga e rua i whakaurua mai e te Wāhanga Whakawhiti Ate o Aotearoa i te Hōhipera o te Tāone o Tāmakimakaurau, mai i tā rātou pātengi raraunga tūroro. E ai ki ngā hua o te tirohanga, tērā ētahi rerekētanga ā-ira mō te ora haeretanga i muri i te whakawhiti ate hou, nā te mea, he maha kē atu ngā tohu o te āwangawanga mō te wahine tēnā i tō te tāne mō te wehe i te hunga tautōhito me te hoki ki te kāinga. Ko ngā tāngata whiwhi ate i hokihoki mai ki te Transplant House i māia kē ake ngā whakaaro mō te hokinga atu ki te kāinga, tēnā i te hunga i hoki tika atu mai i te Wāhanga Whakawhiti Ate o Aotearoa. Hei wāhanga matua mō te hokinga tika ki te kāinga, me whakawhirinaki ngā mahi o muri i te whakawhitinga ate ki te mahi a te hunga tapuhi, mō ngā mahi, mai i ngā akoako tino hira o mua i te pokanga, tae noa atu ki ngā akoranga mō te hoki ki te hapori i runga i te hauora.

Key words / Kupu Matua
Liver transplant recipient / Tangata whiwhi ate whakawhiti; leaving the experts / te whakarere i ngā tautōhito ; quality of life / te kounga o te ora ; survey / rangahau; interviews / ngā uiui.