Grady K L, Jalowiec A, White-Williams C
Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612-3824, USA.
J Heart Lung Transplant. 1999 Mar;18(3):202-10. doi: 10.1016/s1053-2498(98)00048-5.
A multivariate approach to the study of relationships between quality of life and demographic, physical, and psychosocial variables after heart transplantation has not been examined in a large, multi-site sample. The purpose of this study was to describe quality of life, examine relationships between quality of life and demographic, physical, and psychosocial variables, and identify predictors of quality of life in patients who were 1 year post heart transplantation.
Data were collected from a nonrandom sample of adult patients (n = 232) who were 1 year post heart transplantation at a Midwestern or Southern medical center. Nine self-administered instruments and chart review were used to gather data from patients. All tools had adequate psychometric support. Descriptive statistics, Pearson correlations, and step-wise multiple regression were used to analyze data. Level of significance was set at 0.05.
Patients were most satisfied with the areas of quality of life regarding social interaction and least satisfied with their psychological state. Patients experienced an average amount of stress, were coping fairly well, reported overall good quality of life, and were very satisfied with the outcome of their transplant surgery. Nine out of 16 variables were significant predictors of quality of life and explained 66% of the variance in quality of life: less stress, more helpfulness of information from health care providers, better health perception, better compliance with the transplant regimen, more effective coping, less functional disability, less symptom distress, older age, and fewer complications.
Predictors of quality of life at 1 year after heart transplantation were primarily psychological. Additional variance in quality of life was explained by physical, somatic sensation, demographic, and health status variables. Knowledge of these factors provides (1) information to identify patients who are at risk for poor quality of life at 1 year after heart transplantation and (2) direction for the development of interventions to improve quality of life.
在一个大型多中心样本中，尚未对心脏移植后生活质量与人口统计学、身体和心理社会变量之间的关系进行多变量研究。本研究的目的是描述心脏移植术后1年患者的生活质量，研究生活质量与人口统计学、身体和心理社会变量之间的关系，并确定生活质量的预测因素。
数据来自中西部或南部医疗中心心脏移植术后1年的成年患者非随机样本（n = 232）。使用9种自我管理工具和病历审查从患者处收集数据。所有工具均有足够的心理测量学支持。采用描述性统计、Pearson相关性分析和逐步多元回归分析数据。显著性水平设定为0.05。
患者对生活质量中社交互动方面最满意，对心理状态最不满意。患者承受的压力处于平均水平，应对情况尚可，总体生活质量良好，对移植手术结果非常满意。16个变量中有9个是生活质量的显著预测因素，解释了生活质量变异的66%：压力较小、医疗保健提供者提供的信息更有帮助、健康认知更好、对移植方案的依从性更好、应对更有效、功能残疾更少、症状困扰更少、年龄较大以及并发症更少。
心脏移植术后1年生活质量的预测因素主要是心理方面的。生活质量的额外变异由身体、躯体感觉、人口统计学和健康状况变量解释。了解这些因素可提供：（1）识别心脏移植术后1年生活质量差风险患者的信息；（2）改善生活质量干预措施的发展方向。
