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肝肾移植受者焦虑抑郁症状的演变:住院期及移植后12个月阶段

Evolution of anxious-depressive symptomatology in liver and kidney transplant recipients: hospitalization and 12-month post-transplantation phases.

作者信息

Pérez-San-Gregorio M A, Fernández-Jiménez E, Martín-Rodríguez A, Pérez-Bernal J, Gómez Bravo M A

机构信息

Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatments, Seville, Spain.

出版信息

Transplant Proc. 2013;45(10):3656-8. doi: 10.1016/j.transproceed.2013.10.029.

Abstract

OBJECTIVE

The objective of this study was to compare the evolution (hospitalization in the transplantation unit and at 12 months post-transplantation) of anxious and depressive symptomatology in cadaveric transplant recipients as a function of type of organ implanted (liver or kidney).

METHODS

Using a 2 × 2 mixed factorial design, 2 groups were selected: 34 liver transplant recipients and 41 kidney transplant recipients. Both groups were assessed in 2 phases: (1) in the transplantation unit after discharge from the intensive care unit; and (2) 12 months after discharge from the hospital following implantation surgery. The Hospital Anxiety and Depression Scale and the Scale for the Assessment of Social Support were administered. A mixed analysis of covariance was used to assess the influence on transplant recipients' anxious-depressive symptomatology of 2 independent factors: phase (hospitalization in the transplantation unit and at 12 months post-transplantation) and organ (liver and kidney). Perceived social support and age were included as covariates in the analyses. We also calculated d and w as effect size indexes.

RESULTS

Interactive effects of the factors phase and organ were found in the variable anxiety (P = .005). Specifically, the following simple effects were significant: (1) kidney transplant recipients presented more anxious symptomatology while hospitalized in the transplantation unit than at 12 months post-transplantation (P = .001; d = 0.52; medium effect size); and (2) kidney transplant recipients presented more anxious symptomatology than liver transplant recipients while hospitalized in the transplantation unit (P = .013; d = -0.59; medium effect size). No statistically significant effect was obtained for the variable depression.

CONCLUSION

Worse mental health (anxious symptoms) was associated with kidney transplant recipients but not with liver recipients while recovering from the implantation surgery in the transplantation unit.

摘要

目的

本研究的目的是比较尸体器官移植受者焦虑和抑郁症状的演变情况(在移植单元的住院情况以及移植后12个月时的情况),作为所植入器官类型(肝脏或肾脏)的函数。

方法

采用2×2混合因子设计,选取两组:34例肝移植受者和41例肾移植受者。两组均在两个阶段进行评估:(1)在重症监护病房出院后于移植单元;(2)植入手术后出院12个月时。使用医院焦虑抑郁量表和社会支持评定量表进行评定。采用混合协方差分析来评估两个独立因素对移植受者焦虑抑郁症状的影响:阶段(在移植单元的住院情况以及移植后12个月时)和器官(肝脏和肾脏)。在分析中纳入感知到的社会支持和年龄作为协变量。我们还计算了d和w作为效应大小指标。

结果

在焦虑变量中发现了阶段和器官因素的交互作用(P = 0.005)。具体而言,以下简单效应显著:(1)肾移植受者在移植单元住院期间比移植后12个月时表现出更多的焦虑症状(P = 0.001;d = 0.52;中等效应大小);(2)肾移植受者在移植单元住院期间比肝移植受者表现出更多的焦虑症状(P = 0.013;d = -0.59;中等效应大小)。抑郁变量未获得统计学上的显著效应。

结论

在移植单元从植入手术中恢复期间,较差的心理健康状况(焦虑症状)与肾移植受者相关,但与肝移植受者无关。

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