台湾地区心脏移植术后三个阶段健康相关生活质量的变化：术前体外膜肺氧合与非体外膜肺氧合组/临床试验计划组与非临床试验计划组

Changes in health-related quality of life across three post-heart transplantation stages: preoperative extracorporeal membrane versus non-extracorporeal membrane group/clinical trial plan group versus non-clinical trial plan group in Taiwan.

作者信息

Tseng P-H, Wang S-S, Shih F-J

机构信息

Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Transplant Proc. 2012 May;44(4):915-8. doi: 10.1016/j.transproceed.2012.02.011.

DOI:10.1016/j.transproceed.2012.02.011

PMID:22564584

Abstract

AIMS

The aims of this research were to compare changes in overall health-related quality of life (HRQoL), working competence (WC), physical functions (PF), and quality of sleep across 3 crucial post-heart transplantation (HT) stages (1 month, 6 months, and 1 year post-HT) between the following: (1) preoperative extracorporeal membrane (preop-ECMO) versus non-ECMO group and (2) postoperative Clinical Trial Plan (CTP) group versus non-CTP group in Taiwan.

PATIENTS AND METHODS

A between-method triangulation design was used. Subjects who had undergone HT in the last 1-4 years were recruited from a leading medical center in Taipei. Quantitative data were collected using Visual Analog scale (VAS) and Taiwan's version of the World Health Organization Quality of Life (WHOQOL) questionnaire. Semistructured qualitative questions were added to explore the factors influencing the changes in social domains of HRQoL.

RESULTS

A total of 62 heart transplant recipients (HTRs) participated in this study. Their ages ranged from 20 to 70 (mean, 47.16 ± 12.09) years; 80.6% were male. Compared with the subjects with preop-ECMO, HRQoL, WC, and PF of the subjects without preop-ECMO were less at 1 month post-HT; the difference reached statistical significance for HRQoL and PF for 1 month post-HT, but they recovered at the 6 months post-HT stage. HTRs who had participated in the CTP had higher HRQoL and perceived WC in the period of 1 month post-HT, 6 months post-HT, and 1 year post-HT as compared with the group not in CTP; meanwhile, the difference was statistically significant for HRQoL at 1 month post-HT and 6 months post-HT and for PF at 1 month post-HT.

CONCLUSIONS

The efficacy of postop-CTP including HRQoL, WC, and PF was promising across the 3 post-HT stages. Postop-CTP was suggested both clinically and was shown to be statistically significant to HTR's recovery of their health status.

摘要

目的

本研究的目的是比较心脏移植（HT）后3个关键阶段（HT后1个月、6个月和1年）总体健康相关生活质量（HRQoL）、工作能力（WC）、身体功能（PF）和睡眠质量的变化，比较对象如下：（1）术前体外膜肺氧合（术前ECMO）组与非ECMO组；（2）台湾术后临床试验计划（CTP）组与非CTP组。

患者与方法

采用方法间三角测量设计。从台北一家领先的医疗中心招募过去1 - 4年接受过HT的受试者。使用视觉模拟量表（VAS）和台湾版世界卫生组织生活质量（WHOQOL）问卷收集定量数据。增加了半结构化定性问题以探索影响HRQoL社会领域变化的因素。

结果

共有62名心脏移植受者（HTR）参与本研究。他们的年龄在20至70岁之间（平均47.16±12.09岁）；80.6%为男性。与术前有ECMO的受试者相比，术前无ECMO的受试者在HT后1个月时HRQoL、WC和PF较低；HT后1个月时HRQoL和PF的差异具有统计学意义，但在HT后6个月阶段恢复。与未参加CTP的组相比，参加CTP的HTR在HT后1个月、6个月和1年期间的HRQoL和感知WC更高；同时，HT后1个月和6个月时HRQoL以及HT后1个月时PF的差异具有统计学意义。