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异基因干细胞移植后患者的韧性。

Resilience in patients after allogeneic stem cell transplantation.

机构信息

Department of Medicine A/Hematology and Oncology, University of Muenster, Albert-Schweitzer-Campus 1, Bldg. A 1, 48149, Muenster, Germany,

出版信息

Support Care Cancer. 2014 Feb;22(2):487-93. doi: 10.1007/s00520-013-2001-6. Epub 2013 Oct 8.

Abstract

PURPOSE

After undergoing allogeneic stem cell transplantation (alloSCT), patients adapt in very different ways to their taxing situation. Some patients cope very well; others almost seem to fail. Psychosocial variables are important factors for successful reintegration. Besides quality of life, resilience may help to understand the variance in individual differences in adaptation after alloSCT.

METHODS

A pilot study at the University Hospital Muenster, Germany, assessed resilience in patients after alloSCT. The sample included 75 patients (leukemia, lymphoma, myeloma, aplastic anemia) aged 20-76 years. The instruments Resilience Scale RS-25, Hospital Anxiety and Depression Scale, General Self-efficacy Scale, and EORTC QLQ-C30 were used.

RESULTS

Resilience is positively correlated with quality of life (Spearman's rho 0.587) and social functioning (0.472), negatively with anxiety (-0.491) and depression (-0.577). Dividing the sample at the median resilience score of 144 reveals that high-resilience patients report less anxiety (p = 0.008) and depression (p < 0.001); higher physical (p = 0.041), emotional (p = 0.030), and social functioning (p = 0.003); and a better quality of life (p < 0.001) than low-resilience patients. No effects on resilience were found for age, gender, and primary disease entity. The high correlation of resilience and self-efficacy (r = 0.698) shows the strong relationship between the two concepts. Our results indicate a potential influence of the time span from alloSCT on patients' resilience.

CONCLUSIONS

Resilience should be considered as a protective psychosocial factor for patients after alloSCT. A high degree of resilience can help patients to adapt to their situation and to resume their everyday life.

摘要

目的

在接受异基因干细胞移植(alloSCT)后,患者对其紧张的情况有非常不同的适应方式。有些患者应对得很好;而另一些患者则似乎几乎无法应对。社会心理变量是成功重新融入的重要因素。除了生活质量外,适应力可能有助于理解 alloSCT 后个体差异适应的变化。

方法

德国明斯特大学医院进行了一项试点研究,评估了 alloSCT 后患者的适应力。该样本包括 75 名年龄在 20-76 岁的患者(白血病、淋巴瘤、骨髓瘤、再生障碍性贫血)。使用的工具包括适应力量表 RS-25、医院焦虑和抑郁量表、一般自我效能感量表和 EORTC QLQ-C30。

结果

适应力与生活质量呈正相关(Spearman rho 0.587),与社会功能呈正相关(0.472),与焦虑呈负相关(-0.491),与抑郁呈负相关(-0.577)。将样本中位数的适应力得分 144 分为高适应力和低适应力患者,发现高适应力患者报告的焦虑程度较低(p=0.008),抑郁程度较低(p<0.001);更高的身体(p=0.041)、情绪(p=0.030)和社会功能(p=0.003);生活质量更好(p<0.001),而低适应力患者则相反。年龄、性别和主要疾病实体对适应力没有影响。适应力和自我效能感之间的高度相关性(r=0.698)表明了这两个概念之间的紧密关系。我们的结果表明,alloSCT 时间跨度对患者适应力的潜在影响。

结论

适应力应被视为 alloSCT 后患者的一种保护性社会心理因素。高度的适应力可以帮助患者适应自己的处境并重新开始日常生活。

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