• May 1, 2009 Ruth Lilly Auditorium Riley Hospital

Objective: To identify factors are associated with full participation following liver transplant (LT). Participation is defined in this study as role participation in accordance with the Model of Human Occupation. Participation is operationalized through the 10 Roles listed on the Role Checklist. These roles are sorted into the 4 ICF participation domains: 1) Domestic: homemaker, and caregiver; 2) Major Life Activities: worker, student, and volunteer; 3) Inter/Intrapersonal: friend and family member, and; 4) Community/ Social/ and Civic: participant in organizations, hobbyist, religious participant. Full participation is current participation in one role from each domain.

Method: This is a cross-sectional study that obtained and analyzed data from 161 subjects over a three-month period. LT recipients recruited by mail and in the post-transplant clinic were asked to complete and return a survey that included: the NIDDK-QOL assessment and the Role Checklist. Subjects were 75% male with a mean age of 59 (range 37-77). They were more than 90% 3 years post-transplant.

Results: Forty-six percent of the subjects in this study met the criteria for full participation and 54% did not. A logistic regression produced a model for predicting full participation with 72.7% fit for 2 QOL scales: personal function and social role function with persons having higher than mean scores on the NIDDK personal function scale having 1.22-1.67 increased odds of showing full participation. The data about participation in valued roles indicates that although a role may have a high value associated with it, subjects are not necessarily participating in that role (p<.05 for volunteer, worker, student, and caregiver). Pre-transplant MELD score has no impact on post transplant participation.

Conclusion: An occupational therapy program focusing on areas of personal function, and valued social and role participation may enable more individuals to engage in full participation following liver transplantation.