Gangeri Laura, Scrignaro Marta, Bianchi Elisabetta, Borreani Claudia, Bhoorie Sherrie, Mazzaferro Vincenzo
1 Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
2 Department of Psychology, University of Milano-Bicocca, Milano, Italy.
Prog Transplant. 2018 Sep;28(3):236-243. doi: 10.1177/1526924818781569. Epub 2018 Jun 26.
What does it mean to adjust to a liver transplant? Quality of life research has offered an impairment model, defining adjustment as the absence of diagnosed psychological disorder or of limitations in physical functioning. Recently emerging research on posttraumatic growth testifies the prevalence of positive life changes following the life-threatening illnesses. The present study aimed to verify the presence of the posttraumatic growth process in liver transplant patients and its relationship with traditional quality of life.
The research was a longitudinally descriptive study. A sample of 233 liver transplant patients were assessed with the Posttraumatic Growth Inventory and the Functional Assessment of Chronic Illness Therapy General.
Over 50% of patients showed moderate-high levels in all dimensions of the Posttraumatic Growth Inventory. Further posttraumatic growth is correlated with the functional and social dimensions of quality of life construct and not with physical and emotional functioning.
These results confirmed that posttraumatic growth is related to a different definition of well-being than the one traditionally used in the assessment of quality of life. Adjustment to liver transplant is a complex and systemic process, which requires a multidisciplinary approach to be able to support and encourages adaptation through all the needed functional elements. An interesting perspective is offered by the narrative medicine approach, that highlighted the importance to pay specific attention to the words and expression used by patients related to changes in life and not only to traditional words reporting physical status.
适应肝移植意味着什么?生活质量研究提供了一种损伤模型,将适应定义为不存在已诊断的心理障碍或身体功能受限。最近关于创伤后成长的研究证实了危及生命的疾病后积极生活变化的普遍性。本研究旨在验证肝移植患者创伤后成长过程的存在及其与传统生活质量的关系。
该研究是一项纵向描述性研究。对233名肝移植患者样本进行了创伤后成长量表和慢性病治疗功能评估通用量表的评估。
超过50%的患者在创伤后成长量表的所有维度上都表现出中高水平。进一步的创伤后成长与生活质量结构的功能和社会维度相关,而与身体和情感功能无关。
这些结果证实,创伤后成长与传统生活质量评估中使用的幸福定义不同。适应肝移植是一个复杂的系统性过程,需要多学科方法,以便能够通过所有必要的功能要素来支持和鼓励适应。叙事医学方法提供了一个有趣的视角,该方法强调了特别关注患者与生活变化相关的言语和表达的重要性,而不仅仅是报告身体状况的传统言语。