Veater Nicola Lusia, East Linda
Nottingham University Hospitals NHS Trust, Nottingham, UK.
School of Health Sciences, Queen's Medical Centre, Nottingham, UK.
J Ren Care. 2016 Sep;42(3):172-84. doi: 10.1111/jorc.12162. Epub 2016 May 25.
Despite the benefits of receiving a donor kidney, there is evidence of persistent depression amongst the transplant population. Healthcare professionals should endeavour to put in place strategies for the prevention, identification and management of depression.
To critically examine recent research concerning the prevalence, detection and impact of depression amongst kidney transplant recipients, leading to recommendations for practice improvement.
The 'matrix method' was used to identify and review relevant literature. An online search was performed using three electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE® and Web of Science. The search limits were that the papers reported the findings of primary research studies, published in English in a peer-reviewed journal; involved adult participants and were published between 2000 and 2015. Following critical appraisal of the included studies, a review matrix was produced that identified four emerging themes.
The review confirmed that kidney transplant recipients experience less depression than those who receive other renal replacement therapies. However, depressive illness is still more common amongst kidney transplant recipients than the general population. There are many risk factors for depression and there is evidence of an association between depression and mortality in the transplant population. Routine screening for depression is highly recommended yet rarely seen in practice.
Increasing awareness and educating healthcare professionals about depression amongst kidney transplant recipients is essential to allow for earlier identification and treatment. Screening could provide earlier detection of depression and allow for higher social and psychological support for these patients. Further intervention studies and longitudinal assessments would enhance the understanding of the development and effective management of depressive symptoms.
尽管接受供体肾脏有诸多益处，但有证据表明移植人群中存在持续性抑郁。医疗保健专业人员应努力制定预防、识别和管理抑郁的策略。
严格审查近期关于肾移植受者中抑郁的患病率、检测及影响的研究，从而提出改进实践的建议。
采用“矩阵法”识别和审查相关文献。使用三个电子数据库进行在线搜索：护理及相关健康文献累积索引（CINAHL）、医学期刊数据库（MEDLINE®）和科学引文索引（Web of Science）。搜索限制为论文报告的是同行评审期刊上发表的英文原创研究结果；涉及成年参与者且发表于2000年至2015年之间。在对纳入研究进行严格评估后，生成了一个审查矩阵，确定了四个新出现的主题。
该综述证实，肾移植受者比接受其他肾脏替代疗法的患者抑郁程度更低。然而，抑郁疾病在肾移植受者中仍比普通人群更常见。抑郁有许多风险因素，且有证据表明移植人群中抑郁与死亡率之间存在关联。强烈建议进行抑郁的常规筛查，但在实践中很少见到。
提高对肾移植受者抑郁的认识并对医疗保健专业人员进行相关教育，对于早期识别和治疗至关重要。筛查可以更早地发现抑郁，并为这些患者提供更高水平的社会和心理支持。进一步开展干预研究和纵向评估将增进对抑郁症状发展及有效管理的理解。
