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肝移植术后9年内的创伤后成长及其与生活质量的关系:西班牙的一项横断面研究

Post-traumatic growth and its relationship to quality of life up to 9 years after liver transplantation: a cross-sectional study in Spain.

作者信息

Pérez-San-Gregorio María Ángeles, Martín-Rodríguez Agustín, Borda-Mas Mercedes, Avargues-Navarro María Luisa, Pérez-Bernal José, Conrad Rupert, Gómez-Bravo Miguel Ángel

机构信息

Department of Personality, Assessment, and Psychological Treatment, University of Seville, Seville, Spain.

Critical Care and Urgencies, University Hospital Virgen del Rocío of Seville, Seville, Spain.

出版信息

BMJ Open. 2017 Sep 15;7(9):e017455. doi: 10.1136/bmjopen-2017-017455.

Abstract

OBJECTIVE

Little is known concerning post-traumatic growth (PTG) after liver transplantation. Against this backdrop the current study analysed the relationship between PTG and time since transplantation on quality of life. Furthermore, it compared PTG between liver transplant recipients and their caregivers.

DESIGN

Cross-sectional case-control study.

SETTING

University Hospital in Spain.

PARTICIPANTS

240 adult liver transplant recipients who had undergone only one transplantation, with no severe mental disease, were the participants of the study. Specific additional analyses were conducted on the subset of 216 participants for whom caregiver data were available. Moreover, results were compared with a previously recruited general population sample.

OUTCOME MEASURES

All participants completed the Posttraumatic Growth Inventory, and recipients also filled in the 12-Item Short-Form Health Survey. Relevant sociodemographic and clinical parameters were also assessed.

RESULTS

In the sample of 240 recipients, longer time since transplantation (>9 years) was associated with more pain symptoms (p=0.026). Regardless of duration, recipients showed lower scores on most quality of life dimensions than the general population. However, high PTG was associated with a significantly higher score on the vitality quality of life dimension (p=0.021). In recipients with high PTG, specific quality of life dimensions, such as bodily pain (p=0.307), vitality (p=0.890) and mental health (p=0.353), even equalled scores in the general population, whereas scores on general health surpassed them (p=0.006). Furthermore, liver transplant recipients (n=216) compared with their caregivers showed higher total PTG (p<0.001) and higher scores on the subscales relating to others (p<0.001), new possibilities (p<0.001) and appreciation of life (p<0.001).

CONCLUSIONS

Our findings highlight the protective role of PTG in the long-term outcome of liver transplant recipients. Future studies should analyse and develop psychosocial interventions to strengthen PTG in transplant recipients and their caregivers.

摘要

目的

关于肝移植后的创伤后成长(PTG),人们了解甚少。在此背景下,本研究分析了PTG与移植后时间对生活质量的关系。此外,还比较了肝移植受者及其照料者的PTG情况。

设计

横断面病例对照研究。

地点

西班牙的大学医院。

参与者

240名仅接受过一次移植且无严重精神疾病的成年肝移植受者参与了本研究。对有照料者数据的216名参与者子集进行了特定的额外分析。此外,将结果与之前招募的普通人群样本进行了比较。

结局指标

所有参与者均完成了创伤后成长量表,受者还填写了12项简短健康调查问卷。还评估了相关的社会人口统计学和临床参数。

结果

在240名受者样本中,移植后时间较长(>9年)与更多疼痛症状相关(p = 0.026)。无论时间长短,受者在大多数生活质量维度上的得分均低于普通人群。然而,高PTG与生活质量维度中的活力得分显著更高相关(p = 0.021)。在高PTG的受者中,特定的生活质量维度,如身体疼痛(p = 0.307)、活力(p = 0.890)和心理健康(p = 0.353),甚至与普通人群的得分相当,而总体健康得分则超过了他们(p = 0.006)。此外,与照料者相比(n = 216),肝移植受者的PTG总分更高(p < 0.001),在与他人相关(p < 0.001)、新的可能性(p < 0.001)和对生活的感激(p < 0.001)等子量表上的得分也更高。

结论

我们的研究结果突出了PTG在肝移植受者长期预后中的保护作用。未来的研究应分析并开发心理社会干预措施,以增强移植受者及其照料者的PTG。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/5640137/e0401585d13c/bmjopen-2017-017455f01.jpg

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