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肝移植等待名单上患者的应对方式。

Coping styles of patients on the liver transplant waiting list.

作者信息

López-Navas A, Ríos A, Riquelme A, Martínez-Alarcón L, Miras M, Ramírez P, Parrilla P

机构信息

Hospital Universitario Virgen de la Arrixaca, Consejería de Sanidad, Coordinación Autonómica de Trasplantes, Consejería de Sanidad, Servicio Murciano de Salud, Murcia, Spain.

出版信息

Transplant Proc. 2010 Oct;42(8):3149-52. doi: 10.1016/j.transproceed.2010.05.068.

Abstract

INTRODUCTION

Chronic end-stage liver disease is a difficult situation for the patient.

OBJECTIVE

The objective of this study was to analyze the disease coping styles of patients on the liver transplant waiting list.

MATERIALS AND METHODS

The study included 50 patients on the liver transplant waiting list. The instrument used was the Mental Adjustment to Cancer Scale (Ferrero, 94). Coping scales were as follows: fighting spirit, hopelessness, anxious preoccupation, fatalism, and negation.

RESULTS

Only 6% of subjects adapted well, whereas 94% adapted badly: 89% poor fighting spirit, 32% hopelessness, 50% anxious preoccupation, 28% fatalism, and 30% negation. Of those who had a poor fighting spirit, 88% also used another type of maladaptive style. The associated statements were (P<.05) as follows: "I value my life more"; "I don't think about the disease"; "I think about people who are worse off." Regarding hopelessness, 100% of those who confessed hopelessness also showed maladaptive signs. The associated statements were (P<.05) as follows: "I cannot cheer myself up"; "I cannot help myself"; "I've given up." Regarding anxious preoccupation, nearly all of these patients (96%) provided dysfunctional answers. The most associated were (P<.05) as follows: "I don't have any plans"; "I feel a lot of anxiety"; "I'm very angry." Regarding fatalism, all of the patients also had maladaptive behavior. The main types were (P<.05) as follows: "Nothing will change things"; "I cannot control the situation"; "I don't need information." Regarding negation, Only 14% used this style, and in 86% negation was associated with other inadequate coping styles.

CONCLUSIONS

Patients on the liver transplant waiting list were maladaptive to their disease. It is important to establish adequate psychological care for these patients, given the important repercussions in the posttransplantation phase.

摘要

引言

慢性终末期肝病对患者来说是一种艰难的状况。

目的

本研究的目的是分析肝移植等待名单上患者的疾病应对方式。

材料与方法

该研究纳入了50名肝移植等待名单上的患者。使用的工具是癌症心理调适量表(费雷罗,1994年)。应对量表如下:斗志、绝望、焦虑关注、宿命论和否认。

结果

只有6%的受试者适应良好,而94%的受试者适应不良:89%斗志薄弱,32%绝望,50%焦虑关注,28%宿命论,30%否认。在那些斗志薄弱的患者中,88%还采用了另一种适应不良的方式。相关表述如下(P<0.05):“我更珍惜自己的生命”;“我不去想疾病”;“我会想到情况更糟的人”。关于绝望,承认绝望的患者中有100%也表现出适应不良的迹象。相关表述如下(P<0.05):“我无法让自己振作起来”;“我无法自救”;“我已经放弃了”。关于焦虑关注,几乎所有这些患者(96%)都给出了功能失调的回答。最相关的表述如下(P<0.05):“我没有任何计划”;“我感到非常焦虑”;“我非常生气”。关于宿命论,所有患者也都有适应不良的行为。主要类型如下(P<0.05):“什么都改变不了事情”;“我无法控制局面”;“我不需要信息”。关于否认,只有14%的患者采用这种方式,86%的情况下否认与其他不适当的应对方式相关。

结论

肝移植等待名单上的患者对其疾病适应不良。鉴于在移植后阶段有重要影响,为这些患者建立充分的心理护理很重要。

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