Laederach-Hofmann Kurt, Bunzel Brigitta, Freundorfer Edith, Schubert Maria-Theresia
Psychosomatik und Psychosoziale Medizin Inselspital, Universität Bern, Schweiz.
Psychother Psychosom Med Psychol. 2002 Jan;52(1):5-15. doi: 10.1055/s-2002-19663.
This study was conducted to delineate partnership-relation functioning over time and specifically matched to various organs such as heart, liver, and kidney.
Prospective, paralleled case-control-study including patients and their respective partners before and one year after organ transplantation in 23 heart-transplant recipients, 19 liver-transplant patients, and 16 kidney-transplant recipients. To assess partnership functioning, the FB-Z (family assessment measure) of Cierpka and Frevert was used. Statistics included descriptive methods, correlations, and analysis of variance including the items "organ" and "time".
Heart-transplant recipients and their partners show significant better overall measures in their partnership ratings (sum-value) in comparison to liver or kidney patients and their partners. In all patient and partner groups, except in kidney-transplant recipients a significant deterioration over time is discernible in the subscales role performance and emotionality. In respect to the item "organ" significant differences were found in overall functioning and the subscale communication where heart-transplant recipients and their partners have significant better functioning compared to kidney or liver transplant patients. In kidney patients and their partners only communication changes to the better in the time course.
In any organ transplantation the two sides of the coin are important to bear in mind, the one is the live-saving act of transplantation as such, the other is the important distress in the phase before but equally after the operation, mainly in the first year where patients and their respective partners have to be followed and treated even in respect to psychosocial and marital functioning.
本研究旨在描述伴侣关系随时间的变化情况,并特别针对心脏、肝脏和肾脏等不同器官进行匹配研究。
前瞻性平行病例对照研究,纳入了23例心脏移植受者、19例肝脏移植患者和16例肾脏移植受者及其各自的伴侣,分别在器官移植前和移植后一年进行观察。采用Cierpka和Frevert的FB-Z(家庭评估量表)来评估伴侣关系功能。统计方法包括描述性方法、相关性分析以及方差分析,其中涉及“器官”和“时间”两个因素。
与肝脏或肾脏移植患者及其伴侣相比,心脏移植受者及其伴侣在伴侣关系评分(总分)方面的整体表现显著更好。在所有患者及其伴侣组中,除肾脏移植受者外,角色表现和情感性分量表随时间均有显著恶化。在“器官”因素方面,整体功能和沟通分量表存在显著差异,心脏移植受者及其伴侣的功能显著优于肾脏或肝脏移植患者。在肾脏移植患者及其伴侣中,仅沟通功能在随访期间有所改善。
在任何器官移植中,都要牢记两个方面,一方面是移植这一挽救生命的行为本身,另一方面是术前及术后尤其是第一年的重要困扰,即使在心理社会和婚姻功能方面,患者及其伴侣也需要得到随访和治疗。