Jalowiec Anne, Grady Kathleen L, White-Williams Connie
Loyola University, Chicago, Il, USA.
J Cardiopulm Rehabil Prev. 2007 Jan-Feb;27(1):24-32; discussion 33-4. doi: 10.1097/01.hcr.0000265029.25392.6e.
Although heart transplantation (HT) increases survival of heart failure patients, many patients still experience problems afterward that affect functioning.
(1) to compare the functional status of HT patients before transplant versus 1 year after transplant, (2) to identify functional problems 1 year post-transplant, and (3) to identify which variables predicted worse functional status 1 year later.
The sample was 237 adult HT recipients who completed the 1-year post-transplant study booklet. Functional ability was assessed by the Sickness Impact Profile. Paired t tests compared Sickness Impact Profile scores before and after transplant. Medical and demographic data plus patient questionnaire data on Sickness Impact Profile, symptoms, stressors, and compliance were used in the regression.
Sickness Impact Profile functional scores improved significantly from pre-transplant (23.0%) to post-transplant (13.4%); however, many HT recipients still reported problems in 12 functional areas 1 year after surgery. Major problem areas were the following: work (90% of patients), eating (due to dietary restrictions, 87%), social interaction (70%), recreation (63%), home management (62%), and ambulation (54%). Only 26% were working 1 year after transplant; 59% of those working reported health-related problems performing their job. Predictors of worse functional status were greater symptom distress, more stressors, more neurologic problems, depression, female sex, older age, and lower left ventricular ejection fraction (worse cardiac function).
Many HT recipients were still having functional problems and had not reached their full rehabilitation potential by the 1-year anniversary after transplant.
尽管心脏移植（HT）提高了心力衰竭患者的生存率，但许多患者术后仍会出现影响功能的问题。
（1）比较心脏移植患者移植前与移植后1年的功能状态；（2）确定移植后1年的功能问题；（3）确定哪些变量可预测1年后较差的功能状态。
样本为237名成年心脏移植受者，他们完成了移植后1年的研究手册。功能能力通过疾病影响量表进行评估。配对t检验比较了移植前后的疾病影响量表得分。回归分析使用了医疗和人口统计学数据以及患者关于疾病影响量表、症状、压力源和依从性的问卷数据。
疾病影响量表功能得分从移植前的23.0%显著提高到移植后的13.4%；然而，许多心脏移植受者在术后1年仍报告了12个功能领域的问题。主要问题领域如下：工作（90%的患者）、饮食（由于饮食限制，87%）、社交互动（70%）、娱乐（63%）、家庭管理（62%）和行走（54%）。移植后1年只有26%的人在工作；工作的人中59%报告在工作时存在与健康相关的问题。功能状态较差的预测因素包括更大的症状困扰、更多的压力源、更多的神经问题、抑郁、女性、年龄较大以及较低的左心室射血分数（较差的心脏功能）。
许多心脏移植受者仍存在功能问题，在移植后1周年时尚未充分发挥其康复潜力。
