Koller Antje, Denhaerynck Kris, Moons Philip, Steiger Jürg, Bock Andreas, De Geest Sabina
University of Basel, Switzerland.
Prog Transplant. 2010 Mar;20(1):40-6. doi: 10.1177/152692481002000107.
For kidney transplant patients, a lifelong intake of medication is mandatory. Health care workers' prioritization of adverse effects often differs from that of their patients, although patients' experience of adverse effects of medication can trigger nonadherence. Understanding how patients experience symptoms is therefore important.
To present a new method to be used in research to evaluate symptom experience related to adverse effects in adult kidney transplant recipients on maintenance immunosuppressive therapy.
Cross-sectional secondary data analysis.
Three hundred fifty-six adult kidney transplant recipients from 2 Swiss transplant outpatient clinics.
Symptom experience was measured with the Modified Transplant Symptom Occurrence and Symptom Distress Scale. For each item, ridit scores were calculated. A coordinate system with occurrence and distress ratings of each symptom classified symptoms into 4 quadrants: symptoms could have high occurrence/high distress, low occurrence/high distress, high occurrence/low distress, and low occurrence/low distress symptoms. Items farther from the origin represented more extreme profiles.
The proposed method arranges symptoms clearly in sequence of their importance. In our study, fatigue and joint and back pain were the most frequent and distressing symptoms. Symptom profiles for men and women differed: for men impotence and anxiety were key whereas for women listlessness and changed appearance seemed to play important roles.
The 2-dimensional diagram of symptom profiles enables researchers and clinicians to evaluate the impact of symptoms associated with immunosuppressive medications.
对于肾移植患者而言，终身服药是必须的。医护人员对不良反应的优先级划分往往与患者不同，尽管患者对药物不良反应的体验可能会引发不依从行为。因此，了解患者如何体验症状很重要。
介绍一种用于研究的新方法，以评估接受维持性免疫抑制治疗的成年肾移植受者与不良反应相关的症状体验。
横断面二次数据分析。
来自瑞士两家移植门诊的356名成年肾移植受者。
采用改良的移植症状发生与症状困扰量表测量症状体验。对每个项目计算ridit分数。一个根据每种症状的发生频率和困扰程度评级的坐标系将症状分为四个象限：症状可能具有高发生频率/高困扰程度、低发生频率/高困扰程度、高发生频率/低困扰程度以及低发生频率/低困扰程度。离原点越远的项目代表越极端的情况。
所提出的方法按症状的重要性顺序清晰排列症状。在我们的研究中，疲劳以及关节和背部疼痛是最常见且最令人困扰的症状。男性和女性的症状情况不同：对男性而言，阳痿和焦虑是关键症状，而对女性来说，无精打采和外貌变化似乎起着重要作用。
症状情况的二维图使研究人员和临床医生能够评估与免疫抑制药物相关的症状的影响。
