Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B

Ja-Ok Kim; Man Woo Kim; Ja-Sook Kim; Su-Jeong Han; Sehyun Kim

doi:10.7469/kjan.2014.26.3.287

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Kim, Kim, Kim, Han, and Kim: Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B

Original Article

Korean J Adult Nurs 2014;26(3):287-299.

Published online: NaN June 2014

DOI: https://doi.org/10.7469/kjan.2014.26.3.287

Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B

Ja-Ok Kim¹, Man Woo Kim², Ja-Sook Kim³, Su-Jeong Han^4,, Sehyun Kim⁵

^¹Department of Nursing, Wonkwang Health Science University, Iksan

^²Department of Internal Medicine, Chosun University Hospital ․ College of Medicine, Chosun University, Gwangju

^³Department of Nursing, Dongkang College, Gwangju

^⁴Department of Nursing, Konyang University, Daejeon

^⁵Graduate School, Department of Medical Consilience, Dankook University, Yongin, Korea

Corresponding author: Han, Su Jeong Department of Nursing, Konyang University, 158 Kwanjeodong-ro, Seo-gu, Daejon 302-832, Korea. Tel: +82-42-600-6344, Fax: +82-42-600-6314, E-mail: sjhan@konyang.ac.kr

Received 10 February 201418 April 2014 Accepted 24 April 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB).

Methods

A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0.

Results

Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL (R²=.03~.22, p=.041~<.001).

Conclusion

CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.

Keywords: Health-related quality of life, Chronic Hepatitis B

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Table 1.

General Characteristics, Health Behavior and Clinical Characteristics of Participants (N=114

Characteristics	Categories	n (%) or M±SD
Age (year)	＜40	34 (29.8)
	≥40	80 (70.2)
	≥40	46.19±12.85
Gender	Male	94 (82.5)
Gender	Female	20 (17.5)
Spouse	Yes	83 (72.8)
Spouse	No	31 (27.2)
Education level	Below high school	54 (47.4)
Education level	Above college	60 (52.6)
Religion	Yes	62 (54.4)
Religion	No	52 (45.6)
Care provider	Non-medical personnel	91 (79.8)
Care provider	Medical personnel	23 (20.2)
Occupation	Yes	79 (69.3)
Occupation	No	35 (30.7)
Monthly income (10,000 won)	＜100	31 (27.2)
	100~199	34 (29.8)
	200~299	20 (17.6)
	≥300	29 (25.4)
Alcohol drinking	Yes	19 (16.7)
Alcohol drinking	No	95 (83.3)
Smoking	Yes	24 (21.1)
Smoking	No	90 (78.9)
Concomitant disease	Yes	54 (47.4)
Concomitant disease	No	60 (52.6)
Aggravation of disease	Serious (≥5 times ALT)	4 (3.5)
	Moderate (2~＜5 times ALT)	7 (6.1)
	Stable (＜2 times ALT)	103 (90.4)
Drug resistance mutation	Yes	57 (50.0)
Drug resistance mutation	No	57 (50.0)
Medication duration (year)	＜1	24 (21.0)
	1~＜3	28 (24.6)
	3~＜5	36 (31.6)
	≥5	26 (22.8)
Serum liver function test (normal range)
AST (7~40 U/L)		47.93±100.29
ALT (5~57 U/L)		49.67±74.73
Albumin (3.5~5.5 g/dL)		4.51±0.52
Bilirubin (0.2~1.0 mg/dL)		2.98±16.98
ALP (38~126 U/L)		64.11±25.32
GGT (Male: 3~39 U/L, Female: 1~27 U/L)		63.45±93.96

AST=aspartate transaminase; ALT=alanine transaminase; ALP=alkaline phosphatase; GGT=gamma glutamyl transpeptidase.

Table 2.

SF-36 and Liver Disease Targeted Scales of LDQOL 1.0 (N=114)

Variables		M±SD	Range
SF-36	Physical functioning	71.75±19.00	0~85.00
	Role limitation-physical	78.62±27.32	0~100.00
	Bodily pain	60.70±16.97	0~70.00
	General health	50.18±20.32	0~95.00
	Vitality	53.67±21.87	0~93.75
	Social functioning	70.83±22.54	0~87.50
	Role limitation-emotion	57.94±20.80	0~100.00
	Mental health	65.22±17.60	0~85.00
Liver Disease Targeted Scales of LDQOL	Symptoms of liver disease	87.54±14.58	29.41~100.00
	Effects of liver disease	82.67±12.45	32.76~100.00
	Concentration	93.11±12.38	34.29~100.00
	Memory	91.35±13.70	30.00~100.00
	Quality of social interaction	80.67±12.19	36.00~100.00
	Health distress	53.71±12.24	13.33~66.67
	Sexual functioning	80.90±16.44	20.00~100.00
	Sexual problems (n=76)	87.61±16.19	41.67~100.00
	Sleep	70.77±16.26	24.00~100.00
	Loneliness	85.47±15.35	20.00~100.00
	Hopelessness	71.97±18.90	30.00~100.00
	Stigma of liver disease	83.27±18.71	20.00~100.00

LDQOL=liver disease quality of life.

Table 3.

SF-36 according to General Characteristics and Clinical Characteristics (N=114)

Characteristics	Categories	n (%)	SF-36
			PF	RP	BP	GH	VT	SF	RE	MH
			M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD
Age (year)	＜40	34 (29.8)	78.68±11.76	85.29±25.60	63.24±12.73	52.65±21.40	54.41±21.79	71.69±23.30	83.33±25.62	55.44±22.97
	≥40	80 (70.2)	68.81±20.72	75.78±27.69	59.63±18.45	53.36±22.03	53.36±22.03	70.47±22.35	75.83±28.73	59.00±19.86
	t (p)		3.21 (.002)	1.71 (.089)	1.04 (.301)	0.84 (.400)	0.23 (.815)	0.26 (.792)	1.31 (.191)	-0.83 (.406)
Gender	Male	94 (82.5)	74.57±14.97	83.05±24.29	62.23±15.18	51.12±20.48	55.19±22.01	72.07±22.71	82.36±25.66	58.94±20.92
	Female	20 (17.5)	58.50±28.75	57.81±31.60	53.50±22.77	45.75±19.42	46.56±20.22	65.00±21.31	57.92±30.04	53.25±20.08
	t (p)		2.43 (.024)	3.99 (＜.001)	1.63 (.115)	1.07 (.285)	1.61 (.110)	1.27 (.204)	3.75 (＜.001)	1.11 (.269)
Spouse	Yes	83 (72.8)	70.78±19.12	77.56±27.21	61.57±15.42	50.18±19.39	53.61±21.68	70.93±21.57	77.11±28.33	60.30±18.92
	No	31 (27.2)	74.35±18.74	81.45±27.88	58.39±20.67	50.16±11.97	53.83±22.75	80.65±27.16	80.65±27.16	51.61±24.37
	t (p)		-0.89 (.374)	-0.67 (.501)	0.88 (.376)	0.00 (.996)	-0.04 (.963)	0.07 (.938)	-0.60 (.550)	2.01 (.047)
Education level	≤High school	54 (47.4)	69.07±22.53	74.54±28.73	57.96±19.46	48.15±19.94	49.54±21.78	69.21±24.25	73.61±29.26	53.61±21.90
	≥College	60 (52.6)	74.17±14.93	82.29±25.68	63.17±14.08	52.00±20.65	57.40±21.45	72.29±20.98	82.08±26.30	61.83±19.11
	t (p)		-1.43 (.163)	-1.52 (.131)	-1.62 (.109)	-1.01 (.314)	-1.93 (.055)	-0.72 (.469)	-1.61 (.108)	-2.14 (.034)
Care provider	Non-MP	91 (79.8)	70.49±20.49	78.09±28.90	60.22±17.13	49.78±20.98	51.85±22.33	68.68±23.15	78.57±28.41	57.58±21.30
	MP	23 (20.2)	76.74±10.18	80.71±20.29	62.61±16.57	51.74±17.81	60.87±18.68	79.35±17.92	76.09±26.51	59.35±19.09
	t (p)		-2.06 (.042)	-0.40 (.684)	-0.60 (.549)	-0.41 (.681)	-1.78 (.077)	-2.05 (.042)	0.38 (.705)	-0.36 (.718)
Occupation	Yes	79 (69.3)	76.01±12.20	83.86±23.53	63.67±12.63	51.96±19.45	55.54±21.23	73.73±20.47	83.65±24.69	61.77±18.64
	No	35 (30.7)	62.14±26.85	66.79±31.68	54.00±22.91	46.14±21.90	49.46±23.01	64.29±25.75	65.48±30.99	49.29±23.01
	t (p)		2.92 (.006)	2.85 (.006)	2.34 (.024)	1.41 (.159)	1.37 (.172)	2.09 (.038)	3.06 (.003)	3.06 (.003)
Monthly income (10,000 won)	＜100^a	31 (27.2)	65.32±23.38	68.15±30.63	54.19±22.92	42.10±22.57	43.95±25.84	60.08±26.30	67.47±31.43	43.87±22.65
	100~199^b	34 (29.8)	72.06±22.06	80.70±27.54	63.24±14.08	52.94±17.71	55.15±19.25	75.74±20.86	80.64±26.33	60.29±20.07
	200~299^c	20 (17.6)	76.75±9.22	78.44±22.44	64.50±10.50	51.25±19.73	54.06±19.90	72.50±18.41	77.92±26.39	62.00±13.02
	≥300^d	29 (25.4)	74.83±12.92	87.50±23.74	62.07±14.97	54.82±19.52	62.07±18.14	75.43±19.62	86.49±24.44	67.41±16.62
	F (p)		1.94 (.126)	2.72 (.048)	2.24 (.088)	2.46 (.066)	3.78 (.013)	3.55 (.017)	2.56 (.058)	8.56 (＜.001)
	Scheffé						a＜d	a＜b		a＜b＜c＜d
Drinking	Yes	19 (16.7)	77.63±9.33	84.54±24.68	64.21±10.17	52.11±17.90	56.25±22.05	73.06±23.30	85.96±19.26	61.58±20.35
	No	95 (83.3)	70.58±20.22	77.43±27.79	60.00±17.98	49.79±20.83	53.16±21.92	70.39±22.48	76.49±29.20	57.21±20.92
	t (p)		2.36 (.021)	1.03 (.303)	0.98 (.326)	0.45 (.652)	0.56 (.576)	0.46 (.655)	1.77 (.084)	0.83 (.406)
Concomitant disease	Yes	54 (47.4)	64.81±21.67	69.21±31.12	56.30±21.57	45.74±21.42	50.58±23.95	68.52±26.23	70.22±30.53	54.44±23.04
	No	60 (52.6)	78.00±13.63	87.08±20.16	64.67±9.99	54.17±18.55	56.46±19.59	72.92±18.58	85.14±23.47	61.08±18.18
	t (p)		-3.83 (＜.001)	-3.59 (.001)	-2.61 (.011)	-2.25 (.026)	-1.44 (.153)	-1.02 (.309)	-2.90 (.005)	-1.71 (.089)
Aggravation of disease	Serious^a	4 (3.5)	72.33±18.64	79.55±26.77	60.97±16.77	54.55±21.27	54.55±21.27	71.11±22.14	79.69±25.95	58.78±19.87
	Moderate^b	7 (6.1)	62.50±26.29	40.62±27.71	45.00±25.16	32.81±20.00	32.81±20.00	46.87±32.87	18.75±23.93	28.75±16.52
	Stable^c	103 (90.4)	77.50±9.57	90.62±10.82	62.50±15.00	48.43±35.85	48.43±35.85	78.12±18.75	93.75±7.97	58.75±35.91
	F (p)		1.70 (.499)	4.58 (.012)	1.72 (.183)	2.03 (.136)	2.03 (.136)	2.49 (.088)	11.72 (＜.001)	4.17 (.018)
	Scheffé			c, a＞b					c, a＞b

PF=physical function; RP=role physical; BP=bodily pain; GH=general health; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; MP=Medical personnel.

Table 4.

Liver Disease Targeted Scales of LDQOL according to General Characteristics and Clinical Characteristics (N=114)

Characteristics	Categories	n (%)	Liver disease target scale of LDQOL
			Total	SxLD	ELD	Concentration	Memory	QSI	HD	SFun	SProb	Sleep	Loneliness	Hopeless	SLD
			M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD
Age (year)	＜40	34 (29.8)	81.31±10.62	87.72±14.73	85.55±13.22	94.62±10.66	95.69±10.68	79.41±12.34	52.45±13.32	85.97±12.52	93.14±11.87	67.88±19.26	96.24±17.57	73.38±20.07	79.71±18.54
	≥40	80 (70.2)	80.16±9.58	87.48±14.60	81.44±11.98	92.46±13.05	89.50±14.47	81.20±12.17	54.25±11.80	78.75±17.48	86.02±16.98	72.00±14.76	85.15±14.42	71.38±18.49	84.79±18.70
	t (p)		0.56 (.574)	0.08 (.936)	1.62 (.108)	0.85 (.397)	2.53 (.013)	-0.71 (.476)	-0.71 (.475)	2.48 (.015)	1.96 (.057)	-1.24 (.217)	0.34 (.732)	0.51 (.606)	-1.33 (.186)
Gender	Male	94 (82.5)	81.03±9.83	89.11±13.57	84.08±12.15	94.76±9.98	93.30±10.61	79.62±12.08	54.93±11.51	80.23±17.13	87.62±16.04	70.98±16.86	85.49±15.39	72.13±18.28	82.27±19.30
	Female	20 (17.5)	78.02±2.22	80.20±17.12	76.03±11.97	85.43±18.68	82.17±21.39	85.60±11.78	48.00±14.16	88.00±15.19	87.50±19.54	69.80±13.39	85.40±15.59	71.25±22.12	88.00±15.19
	t (p)		1.24 (.217)	2.54 (.012)	2.69 (.008)	2.16 (.042)	2.26 (.034)	-2.05 (.049)	2.34 (.021)	-.94 (.345)	0.01 (.986)	0.29 (.770)	0.02 (.981)	0.18 (.851)	-1.45 (.155)
Spouse	Yes	83 (72.8)	80.70±9.23	88.27±13.28	81.99±12.30	93.08±12.48	90.88±13.23	81.11±12.10	54.74±11.47	80.26±16.08	87.50±16.33	72.67±14.69	85.49±14.30	71.39±18.42	83.29±19.30
	No	31 (27.2)	79.98±11.56	85.61±17.68	84.48±12.87	93.18±12.32	92.58±15.05	79.48±12.55	50.97±13.94	82.63±17.53	88.19±16.07	65.68±19.20	85.42±18.14	73.55±20.38	83.23±17.35
	t (p)		0.34 (.729)	0.86 (.388)	-0.95 (.344)	-0.03 (.970)	-0.58 (.559)	0.63 (.529)	1.47 (.144)	-0.68 (.496)	-0.13 (.893)	2.07 (.040)	0.02 (.982)	-0.54 (.589)	0.01 (.986)
Education level	≤High school	54 (47.4)	79.69±10.16	85.60±14.57	81.26±11.40	91.48±14.65	87.72±16.25	80.52±14.39	53.02±12.49	79.97±17.62	87.50±17.42	72.44±17.02	85.93±13.56	69.17±19.13	85.37±18.55
	≥College	60 (52.6)	81.24±9.63	89.30±14.49	83.94±13.29	94.57±9.81	94.61±9.97	80.80±9.93	54.33±12.08	81.74±15.40	87.71±15.21	69.27±15.53	85.07±16.90	74.50±18.50	81.39±18.82
	t (p)		-0.83 (.406)	-1.35 (.178)	-1.14 (.253)	-1.30 (.194)	-2.69 (.008)	-0.12 (.905)	-0.56 (.571)	-0.57 (.570)	-0.05 (.956)	1.04 (.299)	0.29 (.767)	-1.51 (.133)	1.13 (.259)
Care provider	Non-MP	91 (79.8)	79.84±10.33	86.66±14.74	82.25±13.23	92.18±13.12	91.50±13.79	79.30±12.26	53.63±12.50	80.91±17.10	86.26±17.14	69.89±16.47	84.92±15.75	71.65±19.21	81.61±19.83
	MP	23 (20.2)	83.12±7.40	91.05±13.64	84.33±8.76	96.77±8.10	90.72±13.63	86.09±10.51	54.06±11.41	80.87±13.87	91.67±12.42	74.26±15.20	87.65±13.75	73.26±18.00	89.86±11.57
	t (p)		-1.43 (.155)	-1.29 (.199)	-.71 (.475)	-2.10 (.040)	0.24 (.809)	-2.43 (.016)	-0.15 (.881)	0.01 (.992)	-1.26 (.209)	-1.15 (.251)	-0.76 (.449)	-0.36 (.716)	-2.58 (.012)
Occupation	Yes	79 (69.3)	81.81±9.54	89.70±12.09	85.27±10.09	94.47±10.57	92.83±11.32	80.30±12.12	55.49±10.92	82.28±14.72	88.06±16.05	70.94±15.31	85.97±14.85	74.18±18.46	83.88±19.05
	No	35 (30.7)	77.55±10.09	82.69±18.32	76.80±15.17	90.04±15.47	88.00±17.70	81.49±12.50	49.71±14.17	77.80±19.67	85.94±17.14	70.40±18.44	84.34±16.59	67.00±19.22	81.90±18.14
	t (p)		2.16 (.033)	2.07 (.044)	3.51 (.001)	1.54 (.130)	1.48 (.144)	-0.47 (.635)	2.14 (.037)	1.34 (.181)	0.46 (.645)	0.16 (.872)	0.52 (.603)	1.89 (.061)	0.51 (.605)
Monthly income (10,000 won)	＜100^a	31 (27.2)	75.25±11.47	81.69±17.18	75.47±15.28	88.48±16.04	87.74±17.14	77.55±15.75	46.88±15.51	76.87±20.45	84.62±17.95	65.55±20.20	80.39±20.82	65.00±20.94	78.39±18.62
	100~199^b	34 (29.8)	82.26±7.71	88.32±13.68	84.99±10.06	94.12±11.05	90.69±14.26	83.64±10.76	56.18±9.57	80.88±14.98	85.00±18.94	76.00±11.36	88.71±9.82	75.15±14.64	84.12±18.98
	200~299^c	20 (17.6)	82.10±7.29	92.40±7.51	84.48±10.05	96.14±7.60	95.00±7.98	78.80±9.0	54.83±7.68	82.93±12.84	89.74±1.67	69.80±14.36	86.40±13.76	71.00±18.89	86.33±16.75
	≥300^d	29 (25.4)	80.50±9.87	89.55±14.92	86.39±10.35	94.79±11.20	93.45±11.46	81.79±10.83	57.36±11.18	83.84±15.38	90.67±13.46	70.90±16.52	86.48±14.20	76.38±19.77	85.40±19.71
	F (p)		4.43 (.006)	2.74 (.046)	5.41 (.002)	2.16 (.097)	1.46 (.229)	1.61 (.189)	5.08 (.002)	1.03 (.381)	0.72 (.538)	2.34 (.077)	1.73 (.164)	2.35 (.076)	1.03 (.382)
	Scheffé		a＜b, a＜d		a＜b, a＜d				a＜b, a＜d
Drinking	Yes	19 (16.7)	83.83±6.62	89.53±11.52	87.93±8.81	98.20±3.95	96.32±8.31	81.47±11.79	58.60±10.02	84.44±13.07	92.78±12.14	73.05±18.18	88.42±9.32	71.05±19.41	86.49±16.00
	No	95 (83.3)	79.84±10.30	87.15±15.14	81.62±12.83	81.62±12.83	90.35±14.40	80.51±12.33	52.74±12.45	80.20±17.01	86.34±16.88	70.32±15.91	84.88±16.27	72.16±18.90	82.63±19.22
	t (p)		1.62 (.108)	0.64 (.519)	2.04 (.043)	3.74 (＜.001)	2.47 (.017)	0.32 (.748)	1.92 (.056)	1.02 (.307)	1.69 (.102)	0.66 (.505)	1.30 (.199)	-0.23 (.817)	0.81 (.414)
Concomitant disease	Yes	54 (47.4)	78.81±11.73	84.55±18.10	78.67±14.10	91.85±13.39	88.33±15.86	80.67±13.07	52.16±13.51	77.65±20.59	85.75±18.57	71.78±16.03	83.33±15.94	70.46±20.36	83.40±21.83
	No	60 (52.6)	82.03±7.62	90.25±9.86	86.26±9.52	94.24±11.39	94.06±10.86	80.67±11.46	55.11±10.90	83.83±10.89	89.47±13.38	69.87±16.54	87.40±14.67	73.33±17.56	83.17±15.58
	t (p)		-1.71 (.089)	-2.05 (.043)	-3.40 (.001)	-1.02 (.306)	-2.22 (.029)	0.00 (1.000)	-1.28 (.200)	-1.97 (.052)	-1.00 (.319)	0.62 (.533)	-1.41 (.159)	-0.80 (.421)	0.06 (.949)
Aggravation of disease	f Serious^a	4 (3.5)	81.09±8.60	88.15±13.70	83.04±12.36	93.34±12.00	92.00±13.14	80.97±11.82	54.27±10.94	81.13±16.05	87.81±15.57	71.14±15.35	86.71±13.37	73.00±17.18	84.36±17.55
	Moderate^b	7 (6.1)	61.99±16.08	67.40±29.31	69.39±14.10	79.28±22.05	75.00±22.52	65.00±13.61	33.33±14.40	67.14±82.06	75.00±22.04	57.00±23.40	62.00±20.00	37.50±9.57	58.33±22.02
	Stable^c	103 (90.4)	82.89±19.14	91.17±12.47	84.91±11.29	95.71±8.57	93.33±9.42	82.00±15.49	53.33±26.66	92.14±1.42	100.00±.00	72.00±32.65	77.00±38.00	78.75±29.54	85.83±28.33
	F (p)		8.18 (＜.001)	4.17 (.018)	2.47 (.095)	2.61 (.078)	3.18 (.045)	3.45 (.035)	6.09 (.003)	2.38 (.097)	1.93 (.152)	1.45 (.238)	6.02 (.003)	8.25 (＜.001)	4.02 (.021)
	Scheffé		c, a＞b	c, a＞b					a, c＞b				a＞b	c＞b	c＞b

LDQOL=Liver Disease Quality of Life; SxLD=symptoms of liver disease; ELD=effects of liver disease; QSI=quality of social interaction; HD=health distress; SFun=sexual function; SProb=sexual problems; SLD=stigma of liver disease; MP=Medical personnel.

Table 5.

Variables affecting SF-36 domains and Liver Disease Targeted Scales of LDQOL domain (N=114)

Variables	LDQOL
	SF-36							Liver disease target scale of LDQOL
	PF	RP	BP	VT	SF	RE	MH	SxLD	ELD	Conc	Mem	QSI	HD	SexFun
	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)	β (p)
Age	-.23													-.20
Age	(.008)													(.036)
Male	.23	.35				.33		.23		.28	.32	-.20
	(.014)	(＜.001)				(＜.001)		(.013)		(.003)	(.001)	(.030)
Income (high)				.19			.23
Income (high)				(.041)			(.017)
Occupation (yes)	.21		.27		.20		.20		.30				.23
Occupation (yes)	(.025)		(.004)		(.031)		(.041)		(.001)				(.014)
Care provider	.18				.20							.23
Care provider	(.041)				(.033)							(.010)
F-statistics	7.76	15.93	8.55	4.278	4.74	14.09	8.03	6.31	11.21	9.44	12.58	5.75	6.17	4.45
p	＜.001	＜.001	.004	.041	.011	＜.001	.001	.013	.001	.003	.001	.004	.014	.0.36
R²	.22	.12	.07	.03	.08	.11	.12	.05	.09	.08	.10	.09	.05	.04

LDQOL=Liver disease quality of life; PF=physical function; RP=role physical; BP=bodily pain; VT=vitality; SF=social functioning; RE=role emotion; MH=mental health; SxLD=symptoms of liver disease; ELD=effects of liver disease; Conc=concentration; Mem=memory; QSI=quality of social interaction; HD=health distress; SFun=sexual function.

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