Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Transplantation. 2011 Oct 27;92(8):936-42. doi: 10.1097/TP.0b013e31822e0bb5.
It has been reported that living liver donors may develop psychological or psychosocial impairments after transplantation, although the majority of them do not develop much difficulties. Their postoperative psychological prognosis may be affected by the way they made their decision to donate. The purpose of this study was to investigate the association of donors' preoperative psychological factors with the processes of their individual decision-making to donate and their family-level decision-making to select one donor among themselves.
A total of 165 living liver donor candidates underwent a semistructured interview, several standardized psychological tests, and a quality of life measurement. The results of the tests were compared among the groups classified according to the types of their individual and family decision-making processes.
Donor candidates who made a "postponement decision" had higher trait anxiety and higher alexithymia scores than candidates who made a "deliberate decision," and candidates whose family made a "de facto decision" had higher trait anxiety and higher alexithymia scores than candidates whose family made a "decision of consensus," which indicates that those who have high trait anxiety or alexithymia may tend to take a "postponement" pattern in the individual decision-making process and a "de facto decision" pattern in the family decision-making process.
The results indicate the importance of noting living donors' psychological traits for providing them appropriate preoperative psychological support.
据报道,活体肝移植供者在移植后可能会出现心理或心理社会障碍,但大多数供者不会遇到太多困难。他们术后的心理预后可能会受到他们做出捐献决定的方式的影响。本研究旨在探讨供者术前心理因素与他们个人决策过程以及他们在家庭层面选择一名供者的决策过程之间的关系。
共有 165 名活体肝移植候选者接受了半结构化访谈、几项标准化心理测试和生活质量测量。根据个人和家庭决策过程的类型对供者进行分组,并比较测试结果。
做出“延期决定”的供者候选人比做出“深思熟虑决定”的候选人具有更高的特质焦虑和更高的述情障碍评分,而其家庭做出“事实上的决定”的候选人比做出“共识决定”的候选人具有更高的特质焦虑和更高的述情障碍评分,这表明那些具有高特质焦虑或述情障碍的人可能倾向于在个人决策过程中采取“延期”模式,在家庭决策过程中采取“事实上的决定”模式。
结果表明,注意活体供者的心理特征对为他们提供适当的术前心理支持很重要。