Zhu Xiao, Ming Yingzi, Liu Jia, Liu Lifang, Cheng Ke, Mao Ping
Research Center of Chinese Health Ministry on Transplantation Medicine Engineering and Technology, The Third Affiliated Hospital, Central South University, Changsha, Hunan, China (mainland).
Nursing School of Central South University, Changsha, Hunan, China (mainland).
Ann Transplant. 2020 Feb 18;25:e920984. doi: 10.12659/AOT.920984.
BACKGROUND Sleep disturbance is a common problem in liver transplant recipients, but few studies have confirmed the psychosocial factors associated with sleep quality in patients after liver transplantation. This study aimed to identify the psychosocial factors related to sleep quality among liver transplant patients during outpatient follow-up. MATERIAL AND METHODS A retrospective cross-sectional study was performed in 124 liver transplant patients during outpatient follow-up. All participants completed a general demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Generalized Anxiety Disorder-7 scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the perceived social support scale (PSSS). RESULTS The mean global PSQI score was 6.57 (SD, 4.28), which was significantly higher than the mean score for people with normal sleep quality; 50 (40.3%) recipients were classified as having poor sleep quality (PSQI >7). Among the self-reported sleep problems, 62 (50.0%) participants reported that they had to go to the bathroom at night, 58 (43.5%) woke up in the middle of the night or early morning, 84 (67.7%) reported depression symptoms, and 116 (93.5%) had low-level social support. The global PSQI score was positively correlated with anxiety and depression scores, while the global PSSS score was negatively correlated with anxiety and depression scores (p<0.01). Multiple linear regression analysis showed that the length of the post-liver transplant period, the type of residence, BMI, depressive symptoms, and anxiety symptoms were important factors affecting sleep quality among liver transplant patients (p<0.05). CONCLUSIONS Our findings showed high prevalence and incidence of poor sleep quality in liver transplant recipients in outpatient follow-up, with significant correlations with anxiety, depression, and social support, and it was affected by multiple factors. This indicates a need for further research on the follow-up results of sleep and the benefits of comprehensive interventions involving psychosocial factors in liver transplant recipients in China.
睡眠障碍是肝移植受者的常见问题，但很少有研究证实肝移植术后患者睡眠质量相关的社会心理因素。本研究旨在确定门诊随访期间肝移植患者睡眠质量相关的社会心理因素。
对124例门诊随访的肝移植患者进行回顾性横断面研究。所有参与者均完成了一般人口统计学问卷、匹兹堡睡眠质量指数（PSQI）、广泛性焦虑障碍-7量表（GAD-7）、患者健康问卷-9（PHQ-9）和领悟社会支持量表（PSSS）。
PSQI总均分6.57（标准差，4.28），显著高于睡眠质量正常人群的均分；50例（40.3%）受者睡眠质量差（PSQI>7）。在自我报告的睡眠问题中，62例（50.0%）参与者报告夜间需起床排尿，58例（43.5%）在半夜或清晨醒来，84例（67.7%）报告有抑郁症状，116例（93.5%）社会支持水平低。PSQI总均分与焦虑和抑郁评分呈正相关，而PSSS总均分与焦虑和抑郁评分呈负相关（p<0.01）。多元线性回归分析显示，肝移植术后时间、居住类型、体重指数、抑郁症状和焦虑症状是影响肝移植患者睡眠质量的重要因素（p<0.05）。
我们的研究结果显示门诊随访的肝移植受者睡眠质量差的患病率和发生率较高，与焦虑、抑郁和社会支持显著相关，且受多种因素影响。这表明有必要进一步研究中国肝移植受者的睡眠随访结果以及涉及社会心理因素的综合干预措施的益处。
