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心理健康影响肝移植后的生活质量和康复。

Mental health affects the quality of life and recovery after liver transplantation.

机构信息

Behavioral Health, Henry Ford Health System, Detroit, MI.

出版信息

Liver Transpl. 2013 Nov;19(11):1272-8. doi: 10.1002/lt.23728. Epub 2013 Sep 24.

Abstract

There has been little research examining the effects of mental health before liver transplantation on quality of life (QOL) and recovery after transplantation. Therefore, the purpose of the current study was to examine how pretransplant depression and anxiety affect mental health, QOL, and recovery after transplantation. Eighty-two transplant recipients provided data when they were listed for transplantation and 6 months after transplantation. Pretransplant anxiety predicted posttransplant anxiety (P < 0.001), and there was a trend in predicting posttransplant depression (P = 0.06). Pretransplant depression predicted posttransplant depression (P = 0.03), and there was a trend in predicting posttransplant anxiety (P = 0.06). Additionally, pretransplant anxiety predicted posttransplant QOL for several domains, including Body Pain, Role Limitations Due to Emotional Problems, and Mental Health, as well as the Mental Health Composite Score (P < 0.05). However, in comparison with anxiety, pretransplant depression independently predicted outcomes for more QOL domains, which included Physical Functioning, Role Limitations Due to Physical Problems, General Health, Vitality, and Social Functioning, as well as the Physical Composite Score (P < 0.05). Patients with depression at the baseline were more likely to report incomplete recovery 6 months after transplantation (P < 0.001). With respect to baseline anxiety, there was a trend suggesting that these patients were also more likely to report incomplete recovery (P = 0.09). These findings highlight the importance of evaluating transplant candidates both before and after transplantation for anxiety and depressive symptoms. Once patients with these symptoms are identified, they can be referred for treatment, which may lead to better posttransplant outcomes for mental health, QOL, and recovery.

摘要

在肝移植前心理健康对生活质量 (QOL) 和移植后恢复的影响方面,研究甚少。因此,本研究的目的是检验移植前的抑郁和焦虑如何影响心理健康、生活质量和移植后的恢复。82 名移植受者在被列入移植名单时和移植后 6 个月提供了数据。移植前焦虑预测了移植后焦虑(P < 0.001),且有预测移植后抑郁的趋势(P = 0.06)。移植前抑郁预测了移植后抑郁(P = 0.03),且有预测移植后焦虑的趋势(P = 0.06)。此外,移植前焦虑预测了多个领域的移植后生活质量,包括身体疼痛、因情绪问题导致的角色限制和心理健康,以及心理健康综合评分(P < 0.05)。然而,与焦虑相比,移植前抑郁独立预测了更多生活质量领域的结果,包括身体功能、因身体问题导致的角色限制、一般健康、活力和社会功能,以及身体综合评分(P < 0.05)。基线时患有抑郁症的患者在移植后 6 个月更有可能报告不完全恢复(P < 0.001)。就基线焦虑而言,有一个趋势表明,这些患者也更有可能报告不完全恢复(P = 0.09)。这些发现强调了在移植前和移植后评估焦虑和抑郁症状的重要性。一旦确定了有这些症状的患者,就可以为他们转介治疗,这可能会导致更好的移植后心理健康、生活质量和恢复结果。

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