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心脏移植候选者的教育水平、应对方式以及生活质量的心理和生理方面

Educational level, coping, and psychological and physical aspects of quality of life in heart transplant candidates.

作者信息

Burker Eileen J, Madan Alok, Evon Donna, Finkel Jerry B, Mill Michael R

机构信息

Department of Allied Health Sciences, CB#7205, Medical School Wing E, University of North Carolina, Chapel Hill, NC 27599-7205, USA.

出版信息

Clin Transplant. 2009 Mar-Apr;23(2):233-40. doi: 10.1111/j.1399-0012.2009.00966.x. Epub 2009 Feb 5.

Abstract

OBJECTIVE

To determine whether demographic factors and coping strategies are related to quality of life in heart transplant candidates.

METHOD

Participants were 50 inpatients being evaluated for heart transplant. Coping was measured using the COPE Inventory (1) (J Pers Soc Psychol, 56, 1989, 267). Quality of life was assessed using the SF-36 (2) (Health Survey: Manual and Interpretation Guide, Quality Metric Inc, Lincoln, RI, 2000).

RESULTS

Higher education and less seeking of social support were independently associated with better physical functioning. Higher use of denial was associated with poorer mental health functioning.

CONCLUSIONS

In patients with significant physical limitations, years of education appears to be protective. Less seeking of social support was associated with better physical functioning perhaps because individuals who feel better physically do not feel the need to elicit support. Alternatively, the tendency to not seek assistance could stem from personality characteristics such as avoidance or optimism. Denial was associated with worse mental health functioning. Denying the existence of a stressor may be a high risk coping strategy for patients who are pre-transplant and even more dangerous for those who are post-transplant given the need to be alert to symptoms. Proactive identification of patients at risk for poorer quality of life will allow for more timely psychosocial interventions, which could impact post-transplant outcomes.

摘要

目的

确定人口统计学因素和应对策略是否与心脏移植候选者的生活质量相关。

方法

研究对象为50名正在接受心脏移植评估的住院患者。使用应对方式量表(1)(《人格与社会心理学杂志》,56卷,1989年,第267页)测量应对方式。使用SF-36量表(2)(《健康调查:手册与解读指南》,Quality Metric公司,罗德岛州林肯市,2000年)评估生活质量。

结果

受教育程度较高以及较少寻求社会支持与较好的身体功能独立相关。较多使用否认应对方式与较差的心理健康功能相关。

结论

在身体存在明显限制的患者中,受教育年限似乎具有保护作用。较少寻求社会支持与较好的身体功能相关,这可能是因为身体状况较好的个体感觉没有必要寻求支持。或者,不寻求帮助的倾向可能源于诸如回避或乐观等人格特征。否认与较差的心理健康功能相关。对于移植前的患者,否认应激源的存在可能是一种高风险的应对策略,而对于移植后的患者,鉴于需要警惕症状,这种策略甚至更加危险。积极识别生活质量较差风险较高的患者将有助于更及时地进行心理社会干预,这可能会影响移植后的结果。

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