Department of Psychosomatic Medicine and Psychotherapy, Segeberger Kliniken, Bad Segeberg, Germany. lutz.goetzmann[at]segebergerkliniken.de
Swiss Med Wkly. 2012 Jun 8;142:w13595. doi: 10.4414/smw.2012.13595. eCollection 2012.
A transplant represents a decisive event for patients and their caregivers. This article deals with the attitudes patients and their spouses have towards the transplantation.
In a cross-sectional study, 121 patients and their spouses were surveyed by questionnaire after a heart, lung, liver or kidney transplant. Attitudes were assessed by means of semantic differentials. Based on the results, an 'Attitudes towards Transplantation' Scale was developed. Sense of coherence (SOC-13), quality of life (Sf-36), quality of the relationship (RAS), burnout (BM) and the patient's emotional response to the transplant (TxEQ-D) were additional psychosocial variables measured in order to assess the association between the attitudes and psychosocial characteristics of transplant patients and their spouses.
The majority of patients and their spouses reported positive attitudes towards the transplant, including the attitudes towards medication, their perceived self and fate of being a transplant patient or spouse. Patients and spouses, however, had a negative attitude towards the transplantation in terms of stress and anxiety. Patients reported greater emotional stress from the transplant and rated their post-transplant perceived fate more negatively than their spouses. Attitudes towards the transplant were significantly associated with the sense of coherence and the quality of relationship.
The attitudes of patients and spouses to different aspects of the transplant itself and to being a transplant patient or spouse should be deliberately reconsidered and facilitated in the psychosocial counselling with regard to the comprehensibility, manageability and meaningfulness of the transplant experience as well as to potential conflicts in the partnership.
移植对于患者及其照顾者来说是一个决定性的事件。本文探讨了患者及其配偶对移植的态度。
在一项横断面研究中，对 121 名接受心脏、肺、肝或肾移植的患者及其配偶进行了问卷调查。使用语义差异法评估态度。根据研究结果，开发了一种“移植态度量表”。还测量了感知的综合能力（SOC-13）、生活质量（Sf-36）、关系质量（RAS）、倦怠（BM）和患者对移植的情绪反应（TxEQ-D）等附加心理社会变量，以评估移植患者及其配偶的态度与心理社会特征之间的关联。
大多数患者及其配偶对移植持积极态度，包括对药物、自我感知和作为移植患者或配偶的命运的态度。然而，患者及其配偶对移植带来的压力和焦虑持消极态度。患者报告的移植后情绪压力更大，对移植后感知的命运评价比配偶更负面。对移植的态度与感知的综合能力和关系质量显著相关。
在心理社会咨询中，应仔细重新考虑和促进患者及其配偶对移植本身以及作为移植患者或配偶的不同方面的态度，同时还应考虑到移植经历的可理解性、可管理性和意义，以及伴侣关系中潜在的冲突。
