Divisions of Nephrology and Cardiology, Children's National Hospital, Washington, DC, USA.
Pediatrics and Psychiatry & Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Pediatr Transplant. 2021 Feb;25(1):e13842. doi: 10.1111/petr.13842. Epub 2020 Oct 4.
Research demonstrates that psychological factors are important for positive transplant outcomes, though there is little literature that synthesizes these factors in a comprehensive model among pediatric kidney transplant patients. This review analyzes psychological and psychosocial factors related to medical outcomes and overall well-being post-transplant by utilizing the PPPHM and referencing the existing literature on risk and resilience. Pediatric kidney transplant recipients are more susceptible to mental health concerns such as depression, anxiety, and ADHD, as well as developmental and neurocognitive delays, compared to healthy peers. Complex medical care and psychosocial needs for patients have implications for family functioning, parental and sibling mental health, and youth readiness to transition to adult care. It is important to carefully monitor patient functioning with empirically validated tools and to intervene in a multidisciplinary setting as early as possible to identify patients at risk and reduce potential negative impact. Psychologists are uniquely trained to assess and address these issues and are a valuable component of multidisciplinary, culturally competent care. While research in this expansive field is improving, more data are needed to establish gold standard approaches to mental health and psychosocial care in this population.
研究表明，心理因素对积极的移植结果很重要，但很少有文献能在小儿肾移植患者的综合模型中综合这些因素。本综述通过利用 PPPHM 并参考风险和弹性的现有文献，分析了与移植后医疗结果和整体健康相关的心理和心理社会因素。与健康同龄人相比，儿科肾移植受者更容易出现心理健康问题，如抑郁、焦虑和 ADHD，以及发育和神经认知延迟。患者复杂的医疗和心理社会需求对家庭功能、父母和兄弟姐妹的心理健康以及青少年准备过渡到成人护理都有影响。重要的是，要用经过验证的工具仔细监测患者的功能，并尽早在多学科环境中进行干预，以识别有风险的患者，减少潜在的负面影响。心理学家经过专门培训，可以评估和解决这些问题，是多学科、文化能力强的护理的有价值的组成部分。虽然这一广阔领域的研究正在取得进展，但仍需要更多的数据来确定该人群心理健康和心理社会护理的黄金标准方法。
