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疾病认知和药物信念:对青少年肾移植受者健康相关生活质量的影响。

Illness perceptions and beliefs about medication: impact on health-related quality of life in adolescent kidney transplant recipients.

机构信息

Psychology Department, La Salle University, Philadelphia, PA, USA.

Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

出版信息

Pediatr Transplant. 2021 May;25(3):e13988. doi: 10.1111/petr.13988. Epub 2021 Feb 16.

DOI:10.1111/petr.13988
PMID:33590948
Abstract

Adolescents diagnosed with chronic kidney disease (CKD) who undergo kidney transplantation have to adjust to pervasive effects of chronic illness and life-long treatment maintenance, alongside normative developmental stressors. The way in which adolescent transplant recipients experience and think about their illness as well as their medication regimen can be a crucial factor impacting psychosocial outcomes. Participants were 26 adolescent kidney transplant recipients (μ = 16.8 years, σ = 1.69 years) who completed self-report surveys during a clinic visit. Multiple linear regressions were used to investigate whether adolescents' beliefs about medications and attitudes and perceptions of their illness are associated with their overall quality of life. Adolescents' negative illness perceptions contributed to lower transplant-specific health-related quality of life ratings (ΔR =.305, p < .01). Additionally, adolescent beliefs about their specific medication regimens (ie, personal medication concerns) (ΔR =.342, p < .01), and general beliefs about medication use (ie, harm, overuse) (ΔR =.241, p < .05) also contribute significantly to the variance in their overall quality of life ratings. Adolescent transplant patients in older grades and those in special education endorsed lower quality of life. Cognitive components (eg, beliefs, perceptions) of an adolescent kidney transplant recipient's experience contribute to transplant-related quality of life outcomes. This highlights a point of intervention where cognitive change interventions may be utilized and efficacious in improving health outcomes.

摘要

被诊断患有慢性肾脏疾病 (CKD) 的青少年在接受肾脏移植后,必须适应慢性疾病和终身治疗维持的普遍影响,同时还要应对正常的发展压力。青少年移植受者体验和思考疾病以及他们的药物治疗方案的方式可能是影响心理社会结果的关键因素。参与者是 26 名青少年肾脏移植受者(μ=16.8 岁,σ=1.69 岁),他们在就诊期间完成了自我报告调查。多元线性回归用于研究青少年对药物的信念以及对疾病的态度和看法是否与他们的整体生活质量相关。青少年对疾病的负面看法导致移植特异性健康相关生活质量评分降低(ΔR=.305,p<.01)。此外,青少年对其特定药物治疗方案的信念(即个人药物担忧)(ΔR=.342,p<.01)以及对药物使用的一般信念(即伤害、过度使用)(ΔR=.241,p<.05)也对他们的整体生活质量评分有显著影响。年级较高和接受特殊教育的青少年移植患者的生活质量较低。青少年肾脏移植受者体验的认知成分(如信念、看法)会影响移植相关的生活质量结果。这突出了一个干预点,即认知改变干预可能会被利用并有效地改善健康结果。

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