Morris P L, Jones B
Royal Newcastle Hospital, NSW.
Med J Aust. 1989 Apr 17;150(8):428-32. doi: 10.5694/j.1326-5377.1989.tb136562.x.
After a report which challenged the generally-held view that renal-transplant recipients have a psychological advantage compared with patients who undergo dialysis, we surveyed the quality of life and psychological distress in all patients who were managed by renal transplantation or dialysis at The Royal Newcastle Hospital Renal Unit. A questionnaire was mailed to patients which covered demographic daily illness severity; the quality of life (satisfaction with life in general, general health, and sexual, family and social relationships); a 28-item general-health questionnaire; a life-event schedule; and a locus-of-control scale. The response rate was 88%. Data were obtained on 138 subjects of whom half (69 subjects) were renal-transplant recipients. The other 69 patients were divided between those who underwent haemodialysis at home (24 patients); those who underwent haemodialysis in a hospital centre (24 patients); and those who underwent continuous ambulatory peritoneal dialysis (21 patients). The study showed that while transplant recipients rated highest in the various aspects of quality of life, that of patients who underwent haemodialysis at home was nearly equivalent. Although patients with continuous ambulatory peritoneal dialysis were ranked third in terms of their quality of life, this clearly exceeded that of the group that underwent haemodialysis in a hospital centre, which generally shared very-similar demographic characteristics. Contrary to general expectations, no clear difference was found across the four treatment modalities in the proportion of patients who were disturbed psychologically or who had a history of treatment for "nervous" problems. The results confirm the superiority of renal transplantation in the treatment of end-stage renal disease but highlights the role of continuous ambulatory peritoneal dialysis as a well-tolerated alternative in the treatment of end-stage renal disease.
有一份报告对肾移植受者相比接受透析治疗的患者具有心理优势这一普遍观点提出了质疑。之后，我们对纽卡斯尔皇家医院肾脏科接受肾移植或透析治疗的所有患者的生活质量和心理困扰状况进行了调查。向患者邮寄了一份问卷，内容涵盖人口统计学信息、日常疾病严重程度、生活质量（对总体生活的满意度、总体健康状况以及性、家庭和社会关系）、一份包含28个项目的总体健康问卷、一份生活事件清单以及一份控制源量表。回复率为88%。我们获取了138名受试者的数据，其中一半（69名受试者）是肾移植受者。另外69名患者分为在家接受血液透析的患者（24名）、在医院中心接受血液透析的患者（24名）以及接受持续非卧床腹膜透析的患者（21名）。研究表明，虽然肾移植受者在生活质量的各个方面得分最高，但在家接受血液透析的患者的得分与之几乎相当。尽管接受持续非卧床腹膜透析的患者在生活质量方面排名第三，但其得分明显高于在医院中心接受血液透析的患者组，而这两组患者的人口统计学特征总体非常相似。与普遍预期相反，在心理受困扰或有“神经”问题治疗史的患者比例方面，四种治疗方式之间未发现明显差异。研究结果证实了肾移植在终末期肾病治疗中的优越性，但也凸显了持续非卧床腹膜透析作为终末期肾病一种耐受性良好的替代治疗方法的作用。
