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移植中药物依从性的心理学视角

Psychological perspective of medication adherence in transplantation.

作者信息

De Pasquale Concetta, Veroux Massimiliano, Fornaro Michele, Sinagra Nunzia, Basile Giusi, Gozzo Cecilia, Santini Roberta, Costa Alessandra, Pistorio Maria Luisa

机构信息

Concetta De Pasquale, Massimiliano Veroux, Michele Fornaro, Nunzia Sinagra, Giusi Basile, Cecilia Gozzo, Roberta Santini, Alessandra Costa, Maria Luisa Pistorio, Vascular Surgery and Organ Transplant Unit, Department of Medical, Surgery Sciences and Advanced Technologies "GF Ingrassia", University of Catania, 95123 Catania, Italy.

出版信息

World J Transplant. 2016 Dec 24;6(4):736-742. doi: 10.5500/wjt.v6.i4.736.

Abstract

AIM

To identify the risk factors and the post-transplant psychological symptoms that affect adherence to therapy in a population of kidney transplant recipients.

METHODS

The study examined the psychological variables likely responsible for the non-adherent behavior using a psychological-psychiatric assessment, evaluation of the perception of patients' health status, and an interview regarding the anti-rejection drug therapy assumption. The study included 74 kidney transplant recipients.

RESULTS

Individuals with a higher level of education and more years since transplantation showed better mental balance. Regarding gender, women appeared to be less adherent to therapy. Further, the years since transplantation adversely affected the proper pharmacological assumption. Adherence to therapy did not significantly change with the mental health index.

CONCLUSION

The biopsychosocial illness model provides a conceptual frame of reference in which biological, psychological, and social aspects take on the same importance in the adherence to treatment protocols. For effective management, it is necessary to understand the patients' personal experiences, their assumptions about the disease, health status perception, and mood, and to identify any "barriers" that could cause them to become noncompliant.

摘要

目的

确定影响肾移植受者群体治疗依从性的风险因素及移植后心理症状。

方法

该研究通过心理 - 精神评估、对患者健康状况感知的评估以及关于抗排斥药物治疗服药情况的访谈,来检测可能导致不依从行为的心理变量。该研究纳入了74名肾移植受者。

结果

受教育程度较高且移植后时间较长的个体表现出更好的心理平衡。在性别方面,女性似乎对治疗的依从性较低。此外,移植后的时间对正确服药有不利影响。治疗依从性并未随心理健康指数发生显著变化。

结论

生物心理社会疾病模型提供了一个概念性参考框架,在这个框架中,生物、心理和社会方面在遵循治疗方案方面具有同等重要性。为了进行有效的管理,有必要了解患者的个人经历、他们对疾病的认知、健康状况感知和情绪,并识别任何可能导致他们不依从的“障碍”。

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