Psychosocial adjustment in children after liver transplantation-A two-year longitudinal perspective.

BACKGROUND: Although liver transplantation increases life expectancy in children, they may experience various psychosocial adjustment problems during the post-transplant period, depending on the process they undergo. Therefore, it is important to monitor their psychosocial adjustment over time.This study examined changes in children's hope, quality of life and trauma levels over a two-year period following liver transplantation. MATERIAL- METHOD: Our study was a two-year longitudinal investigation involving 15 children and their parents who were hospitalised at the Paediatric Liver Transplant Clinic of the Liver Transplant Institute at Inonu University Turgut Ozal Medical Centre between January 2018 and February 2021. The children were observed from before surgery, with follow-ups at 1, 3, 6, 12, 18 and 24 months after surgery. Research data was collected using the Child Information Form, the Quality of Life Scale for Children, the Post-Traumatic Emotional Stress Scale for Children and the Hope Scale for Children. Descriptive statistics, Friedman's test, Dunn-Bonferroni post hoc analyses and linear mixed models were employed for data analysis. RESULTS: Our study found that, over time, children's levels of hope and quality of life increased significantly within the specified time intervals, while their trauma levels decreased. In particular, the results of the initial measurements were found to differ significantly from those of the subsequent measurements. Furthermore, linear mixed model analyses revealed that time significantly impacted psychosocial variables, whereas physical variables such as height and weight were not as influential. CONCLUSION: Our study found that children who underwent liver transplantation experienced reduced trauma and improved psychosocial well-being over time. Therefore, comprehensive paediatric nursing care approaches that support regular psychosocial assessment and monitoring of children are important. IMPLICATIONS TO PRACTICE: Routine psychosocial assessments of hope, quality of life and trauma in children following liver transplantation should be integrated into long-term follow-up care.