Griva Konstadina, Ziegelmann Jochen P, Thompson Derek, Jayasena Dakshina, Davenport Andrew, Harrison Michael, Newman Stanton P
Unit of Health Psychology, Department of Psychiatry and Behavioural Sciences, University College London, London, UK.
Nephrol Dial Transplant. 2002 Dec;17(12):2204-11. doi: 10.1093/ndt/17.12.2204.
The specific impact of transplantation on living related donor (LRD) and cadaver (CAD) kidney transplant recipients and their health-related quality of life (HQoL) has received little attention. This study examined the role of sociodemographic, medical and psychological factors in these two groups.
A total of 347 transplant recipients (76 LRD and 271 CAD patients) completed the Short Form 36 Health Survey and Transplant Effects Questionnaire.
Overall, transplant patients showed satisfactory HQoL particularly with respect to emotional well being. HQoL levels were found to be equivalent in both transplant groups. ANCOVAs showed that LRD recipients expressed more guilt in relation to the donor (P<0.001). Multivariate analysis revealed that worry about the viability and functioning of the transplant alone predicted 15.1% of the variance in the SF-36 mental composite score (MCS) whereas age, income, comorbidities and time on dialysis explained 37.8% of the variance in the SF-36 physical composite score (PCS). Multiple regression analyses performed separately for LRD and CAD patients showed that predictors of MCS and PCS between the two groups were similar.
Our results indicate that different forms of transplantation (LRD vs CAD) may lead to different emotional responses albeit with no apparent quality of life differences. In particular, feelings of guilt appear to be prominent in LRD transplantation.
移植对活体亲属供肾(LRD)和尸体供肾(CAD)肾移植受者及其健康相关生活质量(HQoL)的具体影响鲜受关注。本研究探讨了社会人口统计学、医学和心理因素在这两组受者中的作用。
共有347名移植受者(76名LRD患者和271名CAD患者)完成了简短健康调查问卷36项(Short Form 36 Health Survey)和移植影响问卷(Transplant Effects Questionnaire)。
总体而言,移植患者的健康相关生活质量令人满意,尤其是在情绪方面。发现两组移植受者的健康相关生活质量水平相当。协方差分析表明,LRD受者对供者表达了更多的内疚感(P<0.001)。多变量分析显示,仅对移植的存活和功能的担忧就预测了SF-36精神综合评分(MCS)中15.1%的方差,而年龄、收入、合并症和透析时间解释了SF-36身体综合评分(PCS)中37.8%的方差。对LRD和CAD患者分别进行的多元回归分析表明,两组之间MCS和PCS的预测因素相似。
我们的结果表明,不同形式的移植(LRD与CAD)可能导致不同的情绪反应,尽管生活质量没有明显差异。特别是,内疚感在LRD移植中似乎很突出。