Rosenberger Jaroslav, van Dijk Jitse P, Nagyova Iveta, Zezula Ivan, Geckova Andrea Madarasova, Roland Robert, van den Heuvel Wim J A, Groothoff Johan W
Nephrology and Dialysis Center, and Transplantation Department, University Hospital, Kosice, Slovak Republic.
Transplantation. 2006 May 15;81(9):1306-10. doi: 10.1097/01.tp.0000209596.01164.c9.
Patients after kidney transplantation have decreased mortality, morbidity and better quality of life compared to people on dialysis. Major efforts are being directed towards research into graft and patient survival. Research into quality of life is less intensive. The aim of this study was to explore the predictors of perceived health status (PHS) in kidney transplant recipients.
Out of 218 patients after kidney transplantation 138 participated in the study. Linear regression analysis was performed to predict PHS, measured with the SF-36 questionnaire, in three age categories (<40, 40-59, >or=60 years). Independent variables included social support (measured with the Social Support List Discrepancies questionnaire), sociodemographic and medical variables, side effects and compliance.
Predictors of better PHS in patients<40 years were better social support (P<or=0.001), lower creatinine (P<or=0.001) and lower stress from adverse effects (P<or=0.001). In the group of patients aged 40-59 years higher education (P<or=0.05), increased housekeeping activities (P<or=0.01) and lower stress from adverse effects (P<or=0.001) predicted better PHS. In the last age group predictors of better PHS were lower rate of dialysis (P<or=0.05) and posttransplant hospitalizations (P<or=0.01), absence of diabetes mellitus (P<or=0.01) and lower stress from adverse effects (P<or=0.05).
Major differences exist in PHS among kidney transplant recipients depending on their age. Side effects of therapy are the most important predictor of PHS for all age groups. PHS of young patients mostly depends on their renal function and their social support. Education and working activities are most important for middle-aged people whereas in older patients PHS is mostly affected by comorbidity.
与接受透析治疗的患者相比，肾移植患者的死亡率和发病率降低，生活质量更高。目前主要致力于研究移植物和患者的存活率。对生活质量的研究力度较小。本研究的目的是探讨肾移植受者感知健康状况（PHS）的预测因素。
在218例肾移植患者中，138例参与了研究。采用线性回归分析，以预测三个年龄组（<40岁、40 - 59岁、≥60岁）中用SF - 36问卷测量的PHS。自变量包括社会支持（用社会支持列表差异问卷测量）、社会人口学和医学变量、副作用和依从性。
<40岁患者中，较好的社会支持（P≤0.001）、较低的肌酐水平（P≤0.001）和较低的不良反应压力（P≤0.001）是PHS较好的预测因素。在40 - 59岁的患者组中，高等教育程度（P≤0.05）、家务活动增加（P≤0.01）和较低的不良反应压力（P≤0.001）预示着较好的PHS。在最后一个年龄组中，较好的PHS的预测因素是较低的透析率（P≤0.05）和移植后住院率（P≤0.01）、无糖尿病（P≤0.01）和较低的不良反应压力（P≤0.05）。
肾移植受者的PHS因年龄不同存在较大差异。治疗副作用是所有年龄组PHS的最重要预测因素。年轻患者的PHS主要取决于其肾功能和社会支持。教育和工作活动对中年人最重要，而在老年患者中，PHS主要受合并症影响。
