Courage and representations of death in patients who are waiting for a liver transplantation

Figures & data

Table 1. CM avoidance and TDRS interaction on interview Factor 1

Variable	N	%	Mean (SD)
Gender
Male	45	76.6
Female	17	27.4
Age (years)
Range 24–71			56.2 (11.1)
Education
Low	26	41.9
Middle-high	36	58.1
Marital status
Married	46	74.2
Other	16	25.8
Presence of children
No	14	22.6
Yes	48	77.4
Believe in god
No	8	12.9
Yes	54	87.1
Participation in religious practices
No	32	51.6
Yes	30	48.4
Pathology
Cirrhosis HCV/HBV	19	30.6
Cirrhosis HCV/HBV and HCC	12	19.3
Cirrhosis esotossica	13	21.0
Cirrhosis esotossica and HCC	6	9.7
Recidiva	3	4.8
Other	9	14.5
Pathology recoded
Cancer	18	29.0
Other	44	71.0
Time in waiting list (months)
Range 0–120			13.7 (20.3)
MELD
Range 4–30			13.1 (5.4)

Table 2. Descriptive statistics for study variables of current study compared with the respective normative study

Variable	Range	Cronbach’s α	Current study		Normative study
			Mean	SD	Mean	SD
SF-36 Questionnaire
Physical functioning (PF)	0–100	.94	59.03	31.07	79.10	22.34
Role functioning–physical (RP)	0–100	.94	25.40	40.11	72.53	34.59
Role functioning–emotional (RE)	0–100	.98	66.13	46.55	69.66	36.98
Vitality (VT)	0–100	.79	50.89	25.92	58.71	20.2
Pain (PA)	0–100	.95	65.48	40.11	68.31	25.89
Social functioning (SF)	0–100	.88	69.15	32.54	76.33	22.39
Mental health (MH)	0–100	.84	62.84	24.74	63.18	20.22
TDRS Questionnaire
TDRS Total score	6–30	.92	18.27	7.75	17.98	6.05
CM Questionnaire
CM Coping	8–56	.76	46.65	7.45	38.58	7.87
CM Avoidance	4–28	.62	11.11	5.87	11.0	4.21

Notes: SF-36 Questionnaire: Apolone et al. (1997); TDRS Questionnaire: Testoni et al. (2015); CM Questionnaire: Norton and Weiss (2009) adapted by Nota et al.

Table 3. Results of factor analysis for interview items

Item	Factor 1	Factor 2	Factor 3
What did you think at that time? I did not believe it (No = 0; Yes = 1) [Q2b]	.73
What did you think at that time? I was afraid of intervention (No = 0; Yes = 1) [Q3b]	.68
Do you have enough courage to face this experience? (Almost always = 1; Sometimes = 2; No = 3) [Q7]	.67
Now what do you think of transplant? I’m afraid of not succeeding (No = 0; Yes = 1) [Q3c]	.66
What did you think at that time? That they were wrong (No = 0; Yes = 1) [Q2a]	.64
What did you think at that time? I was afraid (No = 0; Yes = 1) [Q2c]	.60
What did you think at that time? I realized that the situation was serious, but that there was a possible solution (No = 0; Yes = 1) [Q2d]	−.57	.55
Does faith help you? (No = 1; Not a lot = 2; A lot = 3) [Q10]	−.55
Now what do you think of transplant? I am not yet convinced that it is the right thing for me (No = 0; Yes = 1) [Q3d]		.70
What do you expect after the transplant? (Go on as before = 1; Improve a little = 2; Nothing = 3) [Q11]		.69
As is the transplant waiting? (Difficult and painful = 1; I do not think about it = 2; With confidence and hope = 3) [Q4]		−.58
Now what do you think of transplant? I look forward to be called for the intervention (No = 0; Yes = 1) [Q3a]	−.45	−.51
In your opinion, where does the courage come from? External factors (No = 0; Yes = 1) [Q8b]		−.44
Do your beloved ones help you face this experience? (A lot = 1; Partially = 2; A little = 3) [Q9]
If you happen to think of the donor, how do you feel? I cannot define, I think about it without emotional involvement (No = 0; Yes = 1) [Q6c]			−.79
If you happen to think of the donor, how do you feel? Gratitude, thankfulness, in general positive emotions (No = 0; Yes = 1) [Q6a]			.73
In your opinion, where does the courage come from? Faith (No = 0; Yes = 1) [Q8c]	−.53		.60
Do you ever think of the donor and his/her biography? (Often = 1; Sometimes = 2; Never = 3) [Q5]			−.55
If you happen to think of the donor, how do you feel? Guilt, regret, sadness (No = 0; Yes = 1) [Q6b]			.49
Cronbach’s α	.75	.63	.67
Range	2–12	2–9	1–7
Mean	5.42	4.18	3.19
SD	2.60	1.89	2.18
Skewness	.61	.68	.16
Kurtosis	−.21	−.56	−1.50

Notes: Factor loadings over .45 are shown in the upper part of the table (retained items for each factor have respective factor loadings in bold); descriptive statistics of three factor scores are shown in the lower part of the table.

Table 4. Correlations among all constructs (N = 62)

	Constructs	1	2	3	4	5	6	7	8	9	10	11	12	13
	SF-36 Questionnaire
1	Physical functioning (PF)	–
2	Role functioning–physical (RP)	.45***	–
3	Role functioning–emotional (RE)	.31*	.45***	–
4	Vitality (VT)	.38**	.48***	.37**	–
5	Pain (PA)	.36**	.39**	.30*	.53***	–
6	Social functioning (SF)	.21	.375**	.26*	.45***	.49***	–
7	Mental health (MH)	.20	.41**	.51**	.64***	.28*	.35**	–
	TDRS Questionnaire
8	TDRS Total score	.11	.00	.17	−.08	.05	.03	−.04	–
	CM Questionnaire
9	CM Fronteggiamento	−.15	−.02	.06	.13	−.15	−.12	.11	−.01	–
10	CM Evitamento	−.22	−.30*	−.21	−.36**	−.15	−.13	−.20	.06	−.36*	–
	Intervista
11	Factor 1–Fear of the intervention	.03	−.33**	−.12	−.35**	−.07	−.04	−.24	.31*	−.40**	.37**	–
12	Factor 2–Desire to avoid the surgery	.32	.06	−.05	−.19	−.11	−.06	−.07	.21	−.19	.11	.39**	–
13	Factor 3–Donor-related thoughts	−.40**	−.14	−.09	−.19	.01	−.07	−.02	−.23	.05	.15	−.07	−.30*	–

^* Significance level at p < .05.

^** Significance level at p < .01.

^*** Significance level at p < .001.

Table 5. Correlations between constructs and participants’ characteristics (N = 62)

Constructs	Participants’ characteristics
	Gender	Age	Education	Marital status	Children	Believe in god	Partecipation	Pathology	Waiting time	MELD
Physical functioning (PF)	.26*	−.31*	.07	−.12	−.12	−.16	−.09	.26*	−.18	−.20
Role functioning–physical (RP)	.19	.01	.01	.01	.13	.03	.13	.22*	−.13	−.32
Role functioning–emotional (RE)	.36**	.03	.01	−.01	.16	−.18	.01	.21	−.07	−.18
Vitality (VT)	.38**	−.03	.12	−.04	.17	−.01	.17	.28*	−.22	−.15
Pain (PA)	.12	.03	−.07	.07	.06	−.14	−.08	.26*	−.22	−.24
Social functioning (SF)	.03	.01	−.05	.01	.07	.01	−.01	.30*	−.25	−.23
Mental health (MH)	.34**	−.05	.15	−.02	.01	.04	.13	.09	−.22	.04
TDRS Total score	.08	.08	−.18	−.06	−.06	−.41**	−.46**	.06	.14	−.15
CM Fronteggiamento	.02	−.09	.02	−.09	.04	.19	.30*	−.23	.21	.39**
CM Evitamento	−.06	.10	−.24	.15	.08	−.08	−.17	.01	.02	.00
Factor 1–Paura dell’Intervento	.10	−.15	−.20	.01	−.15	−.29*	−.31*	−.04	−.16	.01
Factor 2–Desiderio di non sottoporsi all’Intervento	.06	−.16	.08	−.12	−.15	−.12	−.09	−.25	.01	−.01
Factor 3–Pensieri Riguardo il Donatore	−.09	.12	−.16	.17	−.01	.20	.10	−.15	−.12	.31*

Notes: For Gender 0 = female, 1 = male; Age (years); Education 0 = Low, 1 = Middle-high; Marital status 0 = Other, 1 = Married; Children (Presence of children) 0 = No, 1 = Yes; Believe in god 0 = No, 1 = Yes; Participation in religious practices 0 = No, 1 = Yes; Pathology 0 = Other, 1 = Cancer; waiting time for intervention (months).

^* Significance level at p < .05.

^** Significance level at p < .01.

Graph 1. CM avoidance and TDRS interaction on interview Factor 1.

Table 6. Results of hierarchical regression analyses predicting three interview factors

Variable	Factor 1			Factor 2			Factor 3
	β	ΔR^2	R^2	β	ΔR^2	R^2	β	ΔR^2	R^2
Step1: Quality of life		.26*	.26*		.25*	.25*		.22*	.22*
Physical functioning (PF)	.28*			.50**			−.43**
Role functioning–physical (RP)	−.37*			.06			.04
Role functioning–emotional (RE)	.11			−.12			.28
Vitality (VT)	−.44*			−.42*			−.27
Pain (PA)	.17			.04			−.07
Social functioning (SF)	.03			−.13			−.03
Mental health (MH)	.05			.16			.18
Step2: Spirituality and courage		.17**	.42**		.04	.28*		.05	.28*
TDRS Total score	.26*			−.09			.09
CM Fronteggiamento	−.29*			.05			.09
CM Evitamento	.13
Sep3: Interaction		.10*	.52***		.08	.36*		.05	.33*
Fronteggiamento_x_TDRS	.08			−.14			.25
Evitamento_x_TDRS	.37*			.23			.02

^* Significance level at p < .05.

^** Significance level at p < .01.

^*** Significance level at p < .001.

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