成人与儿科心脏移植患者生活质量和心理困扰的比较。

A comparison of quality of life and psychological distress in heart transplantation patients at adult and pediatric ages.

机构信息

Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Psychiatric Clinic, University of Padua, Padua, Italy.

出版信息

Clin Transplant. 2019 May;33(5):e13335. doi: 10.1111/ctr.13335.

DOI:10.1111/ctr.13335

PMID:29935045

Abstract

BACKGROUND

The aim of the current study was to evaluate and compare the quality of life (QOL) and psychological status of adult patients who underwent heart transplant (HTx) at pediatric or adult ages.

METHODS

The population consisted of two groups: patients who received HTx after 18 years old and pediatrics who received HTx between the age of 1 and 18 years. At the time of the study, all patients were over 18 years old. QOL data were collected from patients using 36-item Short-Form Health Survey (SF-36) and psychological distress by the Symptom checklist 90-revised questionnaire (SCL-90-R).

RESULTS

A total of 232 HTx patients were evaluated; 217 were transplanted at an adult age and 15 at a pediatric one. QOL improved significantly in pediatrics patients in the general health perceptions subscale and physical pain subscale than adult patients. The Global Index of the psychological distress did not differ in the two groups, but the pediatric patients registered statistically significant higher scores on the interpersonal sensitivity symptom subscale (adult group 36 ± 0.42 vs pediatric group 81 ± 0.79), the hostility subscale (adult group m 39 ± 0.44 vs pediatric group 73 ± 0.76) and the paranoid ideation subscale (adult group 46 ± 0.46 vs pediatric group 96 ± 1.02).

CONCLUSION

The pediatric heart recipients showed better quality of life, but they show marked sensitivity, hostility and paranoid ideation which increases the risk of mental distress and therefore their adherence to medical treatment.

摘要

背景

本研究旨在评估和比较成年患者在儿科或成人年龄接受心脏移植（HTx）后的生活质量（QOL）和心理状态。

方法

该人群包括两组：18 岁后接受 HTx 的患者和 1-18 岁接受 HTx 的儿科患者。在研究时，所有患者均已超过 18 岁。使用 36 项简明健康调查问卷（SF-36）收集患者的 QOL 数据，使用症状清单 90 修订版问卷（SCL-90-R）评估心理困扰。

结果

共评估了 232 例 HTx 患者；217 例在成人年龄接受移植，15 例在儿科年龄接受移植。儿科患者在总体健康知觉和身体疼痛方面的 QOL 明显优于成人患者。两组的心理困扰全球指数无差异，但儿科患者在人际敏感症状、敌意和偏执观念方面的得分明显更高（成人组 36±0.42 比儿科组 81±0.79、成人组 39±0.44 比儿科组 73±0.76、成人组 46±0.46 比儿科组 96±1.02）。