Jerson Bradley, D'Urso Christine, Arnon Ronen, Miloh Tamir, Iyer Kishore, Kerkar Nanda, Annunziato Rachel A
Department of Psychology, Fordham University, Bronx, NY, USA.
Pediatr Transplant. 2013 Nov;17(7):612-20. doi: 10.1111/petr.12127. Epub 2013 Aug 1.
The purpose of this study was to examine the safety, feasibility, acceptability, and preliminary efficacy of a cross-age peer mentoring program created to improve adherence and psychosocial outcomes for pediatric liver transplant recipients. Twenty-two participants were assigned to a "mentor now" or "mentor later" waitlist control group. Tacrolimus SD, a validated measure of adherence, was assessed for six months pre- and post-intervention for both groups. Self-report measures of self-management and HRQOL were completed at recruitment and three months after training. Participant report indicated the acceptability of the intervention. Clinically significant improvement in adherence was detected. No significant changes on the psychosocial outcome measures at follow-up were observed. This study demonstrated that an outpatient-based mentoring program is a safe, feasible, and acceptable option to incorporate within a pediatric liver transplant program with potential for promising application in other transplantation populations as well. These results also suggest that the program may have been associated with meaningful improvement in adherence, although further evaluation is warranted.
本研究的目的是检验一项跨年龄同伴指导计划的安全性、可行性、可接受性和初步疗效，该计划旨在提高小儿肝移植受者的依从性和心理社会结局。22名参与者被分配到“立即指导”或“稍后指导”的等待名单对照组。两组在干预前和干预后六个月均使用他克莫司谷浓度（Tacrolimus SD）这一经过验证的依从性测量指标进行评估。自我管理和健康相关生活质量（HRQOL）的自我报告测量在招募时和培训后三个月完成。参与者报告表明了该干预措施的可接受性。在依从性方面检测到具有临床意义的改善。随访时心理社会结局指标未观察到显著变化。本研究表明，基于门诊的指导计划是一种安全、可行且可接受的选择，可纳入小儿肝移植计划，也有可能在其他移植人群中得到有前景的应用。这些结果还表明，该计划可能与依从性的有意义改善相关，尽管仍需进一步评估。
