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[心脏移植后的自我评估健康状况和心理症状]

[Self-assessed health and psychological symptoms after heart transplantation].

作者信息

Sivertsen Børge, Relbo Anne, Gullestad Lars, Hellesvik Marit, Grov Ingelin, Andreassen Arne, Simonsen Svein, Geiran Odd, Havik Odd E

机构信息

Institutt for klinisk psykologi Universitetet i Bergen 5015 Bergen.

出版信息

Tidsskr Nor Laegeforen. 2007 Dec 13;127(24):3198-201.

Abstract

BACKGROUND

The purpose of this study was to assess quality of life (QoL, self-reported health) and psychological adjustment in a sample of heart transplanted patients.

MATERIAL AND METHODS

The sample comprised 147 (117 men) Norwegian heart transplanted patients (operated 1983 - 1999). Data on QoL and psychological adjustment were collected during annual routine follow-up controls between 1998 and 2000. The Short Form 36 (SF-36), the Symptom Checklist 90-Revised (SCL-90-R), and Beck Depression Inventory (BDI) were used.

RESULTS

On average, heart transplant recipients reported significantly reduced QoL and increased levels of psychological symptoms compared to a normative population. Recently operated patients reported a generally good QoL compared to the norms, while there was a worsening after 3 years of both the patients' psychological symptoms and QoL, compared to patients who were transplanted less than 3 years ago. The clinical significance was underscored by the BDI; 30 % of the patients were classified as suffering from mild depression (BDI >/= 10) if transplanted more than 3 years ago, compared to 16 % in patients operated less than 3 years ago (p < .05). 62 % of the patients never returned to work and became/remained permanent disability pensioners.

INTERPRETATION

This study demonstrates that heart transplanted patients have a reduced QoL and psychological problems after the transplantation and this seems to worsen with time. Detection and early intervention of psychological symptoms may assist heart transplant survivors in their return to everyday life. The cross-sectional nature of the study makes it difficult to infer causality from these results.

摘要

背景

本研究旨在评估心脏移植患者样本的生活质量(QoL,自我报告的健康状况)和心理调适情况。

材料与方法

样本包括147名(117名男性)挪威心脏移植患者(1983 - 1999年接受手术)。在1998年至2000年的年度常规随访控制期间收集了关于生活质量和心理调适的数据。使用了简明健康状况调查量表(SF - 36)、症状自评量表90修订版(SCL - 90 - R)和贝克抑郁量表(BDI)。

结果

平均而言,与正常人群相比,心脏移植受者报告生活质量显著降低,心理症状水平升高。与正常标准相比,近期接受手术的患者报告生活质量总体良好,而与移植时间不足3年的患者相比,移植3年后患者的心理症状和生活质量均有所恶化。BDI突出了临床意义;如果移植时间超过3年,30%的患者被归类为患有轻度抑郁症(BDI≥10),而移植时间不足3年的患者中这一比例为16%(p <.05)。62%的患者从未重返工作岗位,成为/仍然是永久性残疾抚恤金领取者。

解读

本研究表明,心脏移植患者在移植后生活质量降低且存在心理问题,并且这似乎会随着时间恶化。心理症状的检测和早期干预可能有助于心脏移植幸存者回归日常生活。本研究的横断面性质使得难以从这些结果中推断因果关系。

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