Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Department of Psychology, BC Children's Hospital, Vancouver, BC, Canada.
Pediatr Transplant. 2021 Jun;25(4):e14005. doi: 10.1111/petr.14005. Epub 2021 Mar 26.
Living with end-stage organ failure is associated with an accumulation of traumatic medical events, and despite recovery after solid-organ transplantation (SOT), many children continue to exhibit lower quality of life (QOL). Few studies have examined the relationship between post-traumatic stress disorder (PTSD) and QOL among pediatric SOT recipients. We conducted a retrospective, cross-sectional review of 61 pediatric SOT recipients (12 heart, 30 kidney, and 19 liver) to evaluate the association of PTSD with self-reported QOL. PTSD was measured by the Child Trauma Screening Questionnaire (CTSQ), and QOL was measured using the PedsQL and PedsQL Transplant Module (PedsQL-TM) surveys. Demographics, baseline, and contemporaneous factors were tested for independent association. SOT recipients were 15.2 (12.1-17.6) years old at survey completion. Median CTSQ score was 2 (1-3), highest in kidney recipients, and 13% were identified as high risk for PTSD. Median PedsQL score was 83 (70-91) and significantly associated with the CTSQ score (r = -.68, p < .001). Median PedsQL Transplant Module score was 89 (83-95) and similarly associated with the CTSQ score (r = -.64, p < .001). Age at time of surveys and presence of any disability were also independently associated with PedsQL and PedsQL-TM, respectively. When adjusted for Emotional Functioning, CTSQ remained associated with PedsQL subscores (r = -.65, p < .001). Trauma symptoms are a major modifiable risk factor for lower self-perceived QOL and represent a potentially important target for post-transplant rehabilitation. Additional research is needed to understand the root contributors to PTSD and potential treatments in this population.
患有终末期器官衰竭的患者会经历大量创伤性医疗事件，尽管在进行实体器官移植（SOT）后会康复，但许多儿童的生活质量（QOL）仍会下降。很少有研究探讨儿科 SOT 受者的创伤后应激障碍（PTSD）与 QOL 之间的关系。我们对 61 名儿科 SOT 受者（12 名心脏、30 名肾脏和 19 名肝脏）进行了回顾性横断面研究，以评估 PTSD 与自我报告的 QOL 之间的关系。通过儿童创伤筛查问卷（CTSQ）来衡量 PTSD，通过 PedsQL 和 PedsQL 移植模块（PedsQL-TM）调查来衡量 QOL。测试了人口统计学、基线和同期因素与 PTSD 的独立关联。SOT 受者在完成调查时的年龄为 15.2（12.1-17.6）岁。CTSQ 评分中位数为 2（1-3），在肾脏受者中最高，13%的受者被确定为 PTSD 高危人群。PedsQL 评分中位数为 83（70-91），与 CTSQ 评分显著相关（r=-.68，p<.001）。PedsQL 移植模块评分中位数为 89（83-95），与 CTSQ 评分也显著相关（r=-.64，p<.001）。调查时的年龄和是否存在任何残疾也分别与 PedsQL 和 PedsQL-TM 独立相关。在调整了情绪功能后，CTSQ 与 PedsQL 各分量表仍呈显著相关（r=-.65，p<.001）。创伤症状是导致自我感知 QOL 下降的一个主要可调节风险因素，代表了移植后康复的一个潜在重要目标。需要进一步研究来了解该人群中 PTSD 的根本原因和潜在治疗方法。
