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肝移植受者:个人、社会和环境资源。

Liver transplant recipients: individual, social, and environmental resources.

作者信息

Stilley Carol S, DiMartini Andrea F, Tarter Ralph E, DeVera Michael, Sereika Susan, Dew Mary Amanda, King Jennifer, Flynn William B

机构信息

University of Pittsburgh, PA, USA.

出版信息

Prog Transplant. 2010 Mar;20(1):68-74. doi: 10.1177/152692481002000111.

Abstract

CONTEXT

Patient characteristics are important in the liver transplant population because of proven associations between individual and environmental factors, treatment adherence, and health outcomes in general medical and other transplant populations.

OBJECTIVE

To determine generalizability of the sample to other liver transplant populations and to establish reliability of measures used to assess individual and environmental resources.

DESIGN

Cross-sectional analysis of baseline data in a longitudinal study of adherence and health outcomes.

PARTICIPANTS, SETTING: Ninety first-time adult liver transplant recipients at the University of Pittsburgh Medical Center completed assessments of sociodemographic, health history, psychosocial, and environmental factors shortly after surgery; adherence and health outcomes were tracked throughout the study.

RESULTS

The medical center cohort was older, less racially diverse, and contained more living donors than the national sample. Our sample was generally comparable to the medical center cohort on pretransplant sociodemographic and clinical characteristics. Reliability/internal consistency on psychological measures was similar between our sample and most published norms. The mean scores on all coping scales in our sample were higher than normative. Our patients indicated a more negative perception of family environment and perceived relationships with their primary caregiver more positively than did the normative group.

CONCLUSION

The generalizability of our sample to the parent population and reliability of individual and environmental measures reported here will enable us to examine relationships and the value of patient and contextual resources for predicting treatment adherence and health outcomes among liver transplant recipients.

摘要

背景

由于在一般医疗人群和其他移植人群中,个体因素与环境因素、治疗依从性及健康结局之间已证实存在关联,因此患者特征在肝移植人群中很重要。

目的

确定该样本对其他肝移植人群的可推广性,并确定用于评估个体和环境资源的测量方法的可靠性。

设计

对一项关于依从性和健康结局的纵向研究中的基线数据进行横断面分析。

参与者、研究地点:匹兹堡大学医学中心的90名首次接受肝移植的成年受者在术后不久完成了社会人口学、健康史、心理社会和环境因素的评估;在整个研究过程中对依从性和健康结局进行跟踪。

结果

该医学中心队列的年龄更大,种族多样性更低,活体供者更多,比全国样本更多。我们的样本在移植前的社会人口学和临床特征方面总体上与该医学中心队列相当。我们的样本与大多数已发表的常模在心理测量方面的可靠性/内部一致性相似。我们样本中所有应对量表的平均得分均高于常模。与常模组相比,我们的患者对家庭环境的看法更消极,但对与主要照顾者的关系的看法更积极。

结论

我们样本对总体人群的可推广性以及此处报告的个体和环境测量方法的可靠性,将使我们能够研究患者和背景资源对于预测肝移植受者治疗依从性和健康结局的关系及价值。

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