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在新冠疫情期间,肾移植受者感知到的压力与睡眠质量、失眠、焦虑和抑郁之间的关系。

The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic.

机构信息

Division of Nephrology, Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.

Department of Psychiatry, University of Health Sciences Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey.

出版信息

PLoS One. 2021 Mar 8;16(3):e0248117. doi: 10.1371/journal.pone.0248117. eCollection 2021.

Abstract

BACKGROUND

The psychological distress and sleep problems caused by current Covid-19 outbreak is not well known in kidney transplant recipients. In this study, we aimed to investigate the association between perceived stress with sleep quality, insomnia, anxiety, depression and kidney function in kidney transplant recipients during the Covid-19 pandemic.

MATERIAL AND METHODS

A hundred-six kidney transplant recipients were enrolled. Questionnaire of "Socio-demographics", "Perceived Stress Scale (PSS)", "Pittsburgh Sleep Quality Index (PSQI)", "Insomnia Severity Index (ISI)" and "Hospital Anxiety Depression Scale (HADS)" are performed. The laboratory data is recorded. The perceived stress related to Covid-19 pandemic and its associations were investigated.

RESULTS

The mean age of patients was 44.2±13.3 years, and 65 of the patients (61.3%) were men. Forty-nine (46.2%) of the patients had high-perceived stress; 51 (48.1%) of the patients had poor sleep quality, 40 (37.7%) of the patients had insomnia, 25 (23.6%) of the patients had anxiety and 47 (44.3%) of the patients had depression. The patients having a history of Covid-19 infection in own or closed relatives (9.09±4.17 vs 6.49±4.16, p:0.014) and the patients who have a rejection episode any of time (8.24±5.16 vs 6.37±3.57, p:0.033) have had significantly higher anxiety scores, when they compared to others. The high PSS were positively correlated with PSQI, ISI, HAD-A and HAD-D. Regression analyses revealed that high-perceived stress is an independent predictor of anxiety and depression. There was not significant difference between kidney function with PSS, PSQI, ISI, HAD-A and HAD-D.

CONCLUSIONS

High PSS is positively correlated with poor sleep quality and insomnia and also an independent predictor of anxiety and depression in kidney transplant recipients during the outbreak of Covid-19. As the pandemic is still spreading worldwide quickly early identification and intervention of sleep disturbances and psychiatric disorders are essential to protect graft function with high compliance to treatment in transplantation patients.

摘要

背景

目前新冠疫情给肾移植受者带来的心理困扰和睡眠问题尚未得到充分认识。本研究旨在探讨新冠疫情期间肾移植受者感知压力与睡眠质量、失眠、焦虑、抑郁和肾功能之间的关系。

方法

纳入 106 例肾移植受者,进行“社会人口学”问卷、“感知压力量表(PSS)”、“匹兹堡睡眠质量指数(PSQI)”、“失眠严重程度指数(ISI)”和“医院焦虑抑郁量表(HADS)”。记录实验室数据。调查与新冠疫情相关的感知压力及其相关性。

结果

患者平均年龄为 44.2±13.3 岁,其中 65 例(61.3%)为男性。49 例(46.2%)患者感知压力高;51 例(48.1%)患者睡眠质量差,40 例(37.7%)患者失眠,25 例(23.6%)患者焦虑,47 例(44.3%)患者抑郁。与其他患者相比,自身或密切亲属有新冠感染史的患者(9.09±4.17 比 6.49±4.16,p:0.014)和有排斥反应史的患者(8.24±5.16 比 6.37±3.57,p:0.033)焦虑评分显著更高。高 PSS 与 PSQI、ISI、HAD-A 和 HAD-D 呈正相关。回归分析显示,高感知压力是焦虑和抑郁的独立预测因子。肾功能与 PSS、PSQI、ISI、HAD-A 和 HAD-D 无显著差异。

结论

在新冠疫情期间,高 PSS 与睡眠质量差和失眠呈正相关,也是肾移植受者焦虑和抑郁的独立预测因子。由于大流行在全球范围内迅速蔓延,早期识别和干预睡眠障碍和精神障碍对于保护移植物功能和提高移植患者的治疗依从性至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27cb/7939354/17b985eb3542/pone.0248117.g001.jpg

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