Physical Activity and Fatigue in Caregivers Before and After Liver Transplantation

Investigation of Caregiver Physical Activity and Fatigue Levels Before and After Liver Transplantation

Caregivers of liver transplant recipients often experience substantial physical and psychological demands during the transplantation process. These responsibilities may influence caregivers' fatigue levels, caregiving burden, and physical activity patterns. Understanding these changes is important for protecting caregivers' health and supporting the long-term care process.

The aim of this study was to examine changes in fatigue severity, caregiver burden, and physical activity levels among caregivers of liver transplant recipients before and after liver transplantation. A total of 119 caregivers participated in the study. Assessments were conducted at three time points: during the pre-transplant hospital phase, at 90 days after transplantation, and at 180 days after transplantation.

Fatigue severity was measured using the Fatigue Severity Scale, caregiver burden was assessed using the Zarit Burden Interview, and physical activity levels were evaluated using the International Physical Activity Questionnaire-Short Form. The findings of this study aim to provide insight into the changes experienced by caregivers during the transplantation process and to contribute to the development of strategies that support caregiver well-being.

Study Overview

• Status: Completed
• Conditions: Liver Transplantation
• Intervention / Treatment: Other: Observational assessment of caregivers without any intervention.

Detailed Description

Liver transplantation is an effective treatment for patients with end-stage liver disease and significantly improves survival and quality of life. However, the transplantation process not only affects recipients but also places considerable physical and psychological demands on caregivers. Caregivers are responsible for assisting patients with daily activities, monitoring medical treatments, and supporting the recovery process. These responsibilities may lead to increased fatigue, caregiver burden, and changes in physical activity patterns.

Although previous studies have examined caregiver burden and fatigue in different chronic diseases, limited research has investigated these parameters among caregivers of liver transplant recipients, particularly during different stages of the transplantation process. Understanding these changes is important for protecting caregiver health and improving long-term care outcomes for transplant recipients.

The present study aimed to investigate changes in fatigue severity, caregiver burden, and physical activity levels among caregivers of liver transplant recipients before and after liver transplantation. The study was conducted at the Liver Transplantation Institute Hospital of Inonu University between December 2024 and February 2026. Caregivers responsible for the care of patients undergoing liver transplantation were included in the study.

Data were collected at three different time points: during the pre-transplant hospital period, at postoperative day 90, and at postoperative day 180. Fatigue severity was evaluated using the Fatigue Severity Scale (FSS), caregiver burden was assessed using the Zarit Burden Interview (ZBI), and physical activity levels were measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF).

The study was designed to evaluate how caregiver fatigue, caregiving burden, and physical activity levels change over time during the transplantation process and to identify factors associated with these outcomes. The findings may help improve awareness of caregiver health and contribute to the development of supportive strategies for caregivers involved in the liver transplantation process.

• Study Type: Observational
• Enrollment (Actual): 119

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Malatya, Turkey (Türkiye), 44090
    • Inonu University Turgut Ozal Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of informal caregivers of patients undergoing liver transplantation at the Liver Transplantation Institute Hospital of Inonu University. Caregivers were responsible for providing daily support and assistance to liver transplant recipients during the transplantation process. A total of 119 caregivers participated in the study and were evaluated at three time points: during the pre-transplant hospital period, at postoperative day 90, and at postoperative day 180.

Description

Inclusion Criteria:

• Being responsible for the care of a patient undergoing liver transplantation,
• Being between 18 and 65 years of age,
• Having sufficient literacy to understand the purpose of the study and the forms to be completed.

Exclusion Criteria:

• Not being accepted into the study,
• Having a limitation or comorbid condition that would interfere with the tests,
• Having taken a break from caregiving for a certain period of time.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Caregivers of Liver Transplant Recipients; This cohort consisted of informal caregivers of patients undergoing liver transplantation. Caregivers were responsible for providing daily support to liver transplant recipients during the transplantation process. Participants were evaluated at three different time points: during the pre-transplant hospital period, at postoperative day 90, and at postoperative day 180. Fatigue severity, caregiver burden, and physical activity levels were assessed using the Fatigue Severity Scale (FSS), Zarit Burden Interview (ZBI), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF).

Other: Observational assessment of caregivers without any intervention.; This study did not include any therapeutic intervention. It was an observational study in which caregivers of liver transplant recipients were evaluated at different time points. Fatigue severity, caregiver burden, and physical activity levels were assessed using standardized questionnaires including the Fatigue Severity Scale (FSS), Zarit Burden Interview (ZBI), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fatigue Severity Scale Total Score	Fatigue severity will be assessed using the Fatigue Severity Scale (FSS). The scale consists of 9 items scored from 1 to 7. Total scores range from 9 to 63, with higher scores indicating greater fatigue severity.	Pre-transplant period, postoperative day 90, and postoperative day 180
Caregiver Burden (Zarit Burden Interview Total Score)	Caregiver burden will be assessed using the Zarit Burden Interview (ZBI). The scale consists of 22 items scored on a 5-point Likert scale ranging from 0 to 4. Total scores range from 0 to 88, with higher scores indicating greater caregiver burden.	Pre-transplant period, postoperative day 90, and postoperative day 180
Physical Activity Level (International Physical Activity Questionnaire-Short Form Total Score)	Physical activity levels will be assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The questionnaire evaluates the frequency and duration of walking, moderate-intensity, and vigorous-intensity physical activities performed during the last seven days. Participants are classified into physical activity categories according to standard IPAQ scoring procedures.	Pre-transplant period, postoperative day 90, and postoperative day 180

Collaborators and Investigators

• Sponsor: Hasan Kalyoncu University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2024
• Primary Completion (Actual): December 25, 2025
• Study Completion (Actual): February 3, 2026

Study Registration Dates

• First Submitted: March 9, 2026
• First Submitted That Met QC Criteria: March 9, 2026
• First Posted (Actual): March 13, 2026

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Liver transplantation; physical activity; fatigue; caregiver; care burden
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Caregiver Burden; Fatigue; Motor Activity
• Other Study ID Numbers: 2024-6657

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: It has not yet been determined whether individual participant data will be shared. Data sharing will be considered upon reasonable request and in accordance with institutional policies and ethical regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No