Identifying Perceived Barriers and Facilitators Toward a Liver Transplantation Prehabilitation

Study Overview
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Brief Summary
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The purpose of this study is to formally identify patient and caregiver perceived needs, barriers, and facilitators to inform the development of a home-based multimodal prehabilitation program for potential LT candidates.

Detailed Description
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After being informed about the study and potential risks, all participants (patients and caregivers) giving written informed consent will be invited to participate in one of three research activities: interviews (n=10), nominal group technique meetings (n=64), or card-sorting and rating survey (n=40).

Official Title
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Identifying Perceived Barriers and Facilitators to Inform the Development of a Liver Transplantation Prehabilitation Intervention

Conditions
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Liver Transplant; Complications

Intervention / Treatment
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* Behavioral: Prehabilitation intervention
* Behavioral: Caregiver intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Liver transplant (LT) candidates are: Adult ESLD patients (age=19-74 years) who are assigned to the LT waitlist English-speaking No contraindication to moderate intensity physical activities Physician clearance for participation in moderate intensity physical activities No history of dementia or organic brain syndrome Caregivers: Adult (age≥ 19 years) English-speaking Provide direct care to LT candidates Exclusion Criteria: Inability to communicate verbally in English Documentation of cognitive deficits

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 74 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| End-stage liver disease (ESLD) patients<br>These potential liver transplant candidates are patients with end-stage liver disease (ESLD) who have been assigned to the liver transplant waitlist. | Behavioral: Prehabilitation intervention<br>* The investigators will identify participants' perceived important information to develop a prehabilitation intervention in this study. Prehabilitation intervention consisting of physical activities, nutrition, and stress management.<br>|
| Caregivers of potential liver transplant candidates<br>They are the primary caregivers for the patients. | Behavioral: Caregiver intervention<br>* The investigators will provide caregivers with variety of educational resources for patients experiencing ESLD.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Liver frailty index (LFI) score | Change from baseline in liver frailty index score at 3 months; the higher LFI scores indicate a higher degree of frailty. LFI<3.2: robust, LFI=3.2-4.4: prefrail, LFI>=4.5: Frail. | From baseline through 3 months | 
| Caregiver burden measured using Zarit Burden Interview short form (ZBI-12) | Change from baseline in the total ZBI-12 scores at 3 months. The total ZBI-12 score is the summation of 12 items, ranging from 0 to 48; the higher scores indicate higher burden (0-10:no to mild burden; 10-20: mild to moderate burden), and >20: high burden. | From baseline through 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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end-stage liver disease (ESLD), frailty, prehabilitation