De Pasquale Concetta, Conti Daniela, Pistorio Maria Luisa, Fatuzzo Pasquale, Veroux Massimiliano, Di Nuovo Santo
Vascular Surgery and Organ Transplant Unit, Department of Medical, Surgery Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy.
Department of Educational Sciences, University of Catania, Catania, Italy.
PLoS One. 2017 Jun 30;12(6):e0180077. doi: 10.1371/journal.pone.0180077. eCollection 2017.
The aim of the study was to perform an analysis of the emotional reactions, perception of stressful life and behavioural changes related to Haemodialysis (HD) in order to identify those variables that can improve lifestyle and the adherence to treatment. Some psychometric assessment, such as the Cognitive Behavioural Assessment, Hospital Form, (CBA-H) and the Health Survey (SF-36), which provides two indexes: the Physical Component Score (PCS) and the Mental Component Score (MCS), are suitable to assess a patient's psychological and behavioural style and their health-related quality of life. The study involved 37 Italian out-patients with end-stage renal disease under HD therapy. We calculated the Spearman correlation between variables of CBA-H, SF-36, age and time on HD. We also performed a multivariate linear regression using the CBA-H variables as predictors and PCS and MCS as dependent variables. From the CBA-H, 95% of participants self-reported psychological characteristics comparable to Type A personality, which identifies an anxious, hyperactive and hostile subject. Physical limitations were found to be directly proportional to the time on dialysis (rs = -0.42). The condition of perceived stress worsens the state of mental health (rs = -0.68) and general health perception (rs = -0.44). The condition of vital exhaustion correlates both the PCS and the MCS (p<0.01) with possible outcomes of physical and mental illness. The psychological wellbeing of a dialyzed patient could be due to the combination of several factors, including life parameters, the positive perception of psychosocial outcomes, and the perceived quality of life. A multidisciplinary team (neurologists, psychiatrists, psychologists, and nurses) is essential to plan effective psychological and psychotherapeutic interventions to improve a mind-body integration.
本研究的目的是分析与血液透析(HD)相关的情绪反应、对压力性生活的认知以及行为变化,以确定那些能够改善生活方式和治疗依从性的变量。一些心理测量评估方法,如认知行为评估、医院量表(CBA-H)和健康调查(SF-36),后者提供两个指标:身体成分得分(PCS)和心理成分得分(MCS),适用于评估患者的心理和行为方式及其与健康相关的生活质量。该研究纳入了37名接受HD治疗的意大利终末期肾病门诊患者。我们计算了CBA-H、SF-36、年龄和HD治疗时间各变量之间的Spearman相关性。我们还进行了多元线性回归分析,将CBA-H变量作为预测因子,PCS和MCS作为因变量。从CBA-H量表来看,95%的参与者自我报告的心理特征与A型人格相当,A型人格特征为焦虑、多动和敌意。发现身体限制与透析时间成正比(rs = -0.42)。感知到的压力状况会使心理健康状况恶化(rs = -0.68)以及总体健康感知恶化(rs = -0.44)。活力耗竭状况与PCS和MCS均相关(p<0.01),且可能导致身心疾病。透析患者的心理健康可能是多种因素共同作用的结果,包括生活参数、对心理社会结果的积极认知以及感知到的生活质量。一个多学科团队(神经科医生、精神科医生、心理学家和护士)对于规划有效的心理和心理治疗干预措施以促进身心整合至关重要。