Harper R G, Wager J, Chacko R C
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA.
J Clin Psychol Med Settings. 2010 Mar;17(1):71-6. doi: 10.1007/s10880-009-9181-8.
This exploratory study attempted to identify characteristics of patients selected for transplant compared to those who had not demonstrated 6 months alcohol, drug and tobacco abstinence at the time of candidacy assessment. In a consecutive sample of 112 patients referred for liver transplant, almost half failed this criteria. Comparisons on psychometric measures of coping, social support, and health status revealed noncompliant patients to be significantly less authority abiding, less concerned about their illness, and less spiritually-oriented. Persisting alcohol use was paradoxically associated with greater psychosocial support whereas depression was related to smoking. Prior drug use was associated with more cognitive symptom complaints, emotional constriction, a vulnerability to feel dejection and a proneness to abuse medications These findings were discussed as a possible opportunity to identify and address characteristics of transplant candidates to reduce their risk of perpetuating noncompliance while competing for a life saving intervention.
这项探索性研究试图确定被选作移植的患者与那些在候选资格评估时未达到6个月戒酒、戒毒和戒烟标准的患者的特征。在连续入选的112例接受肝移植评估的患者样本中，近一半未达到该标准。在应对方式、社会支持和健康状况的心理测量指标方面的比较显示，不依从的患者明显更不遵守权威、对自己的疾病不太关心且精神导向性较低。矛盾的是，持续饮酒与更多的社会心理支持相关，而抑郁与吸烟有关。既往吸毒与更多的认知症状主诉、情绪受限、易感到沮丧及有药物滥用倾向有关。这些发现被视为一个可能的契机，以识别和解决移植候选者的特征，从而在他们竞争挽救生命的干预措施时降低其持续不依从的风险。
