Schulz Torben, Niesing Jan, Homan van der Heide Jaap J, Westerhuis Ralf, Ploeg Rutger J, Ranchor Adelita V
Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands.
Br J Health Psychol. 2014 Nov;19(4):823-38. doi: 10.1111/bjhp.12081. Epub 2013 Dec 12.
Previous research suggests that prior to kidney transplantation, patients overestimate their post-transplant quality of life (QoL). The current study aimed to corroborate these findings, identify determinants of QoL overestimation, examine its association with subsequent distress, and clarify the role of optimism.
Prospective observational study.
Physical, psychological, and social QoL expectations, actual QoL, and distress (GHQ-12) of participants (56% male) were prospectively assessed before (T0; n = 228) and 3 (T1; n = 149), 6 (T2; n = 146), and 12 (T3; n = 114) months after successful transplantation.
Patients who were treated with haemodialysis before transplantation reported greater physical QoL overestimation than those who received treatment with peritoneal dialysis. Neither physical nor social QoL overestimation at T1 was prospectively associated with increased distress at T2 or T3. The interaction between optimism and social QoL overestimation at T1 (β = -.56, p < .001) for distress at T2 was significant, with patients low in optimism experiencing more distress after QoL overestimation.
QoL overestimation is not associated with subsequent distress. Findings suggest that patients low in optimism are more vulnerable to distress following QoL overestimation.
What is already known on this subject? Kidney transplantation improves patients' quality of life. Prior to kidney transplantation, patients overestimate the scale of this improvement. What does this study add? Quality of life overestimation is not associated with subsequent distress. When optimism is low, kidney transplant recipients experience higher distress following quality of life overestimation.
先前的研究表明，在肾移植前，患者高估了他们移植后的生活质量（QoL）。本研究旨在证实这些发现，确定生活质量高估的决定因素，研究其与随后的痛苦之间的关联，并阐明乐观主义的作用。
前瞻性观察研究。
前瞻性评估参与者（56%为男性）在成功移植前（T0；n = 228）以及移植后3个月（T1；n = 149）、6个月（T2；n = 146）和12个月（T3；n = 114）时的身体、心理和社会生活质量期望、实际生活质量以及痛苦程度（GHQ - 12）。
移植前接受血液透析治疗的患者比接受腹膜透析治疗的患者报告了更高的身体生活质量高估。T1时身体或社会生活质量高估均与T2或T3时痛苦增加无前瞻性关联。T1时乐观主义与社会生活质量高估之间的交互作用对T2时的痛苦有显著影响（β = -0.56，p < 0.001），乐观程度低的患者在生活质量高估后经历更多痛苦。
生活质量高估与随后的痛苦无关。研究结果表明，乐观程度低的患者在生活质量高估后更容易痛苦。
关于该主题已知的内容是什么？肾移植可改善患者的生活质量。在肾移植前，患者高估了这种改善的程度。本研究增加了什么？生活质量高估与随后的痛苦无关。当乐观程度低时，肾移植受者在生活质量高估后经历更高的痛苦。
