Tang James, Kerklaan Jasmijn, Wong Germaine, Howell Martin, Scholes-Robertson Nicole, Guha Chandana, Kelly Ayano, Tong Allison
Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Am J Transplant. 2021 Oct;21(10):3369-3387. doi: 10.1111/ajt.16613. Epub 2021 Jun 15.
Medicine-taking among transplant recipients is a complex and ubiquitous task with significant impacts on outcomes. This study aimed to describe the perspectives and experiences of medicine-taking in adult solid organ transplant recipients. Electronic databases were searched to July 2020, and thematic synthesis was used to analyze the data. From 119 studies (n = 2901), we identified six themes: threats to identity and ambitions (impaired self-image, restricting goals and roles, loss of financial independence); navigating through uncertainty and distrust (lacking tangible/perceptible benefits, unprepared for side effects, isolation in decision-making); alleviating treatment burdens (establishing and mastering routines, counteracting side effects, preparing for the unexpected); gaining and seeking confidence (clarity with knowledge, reassurance through collective experiences, focusing on the future outlook); recalibrating to a new normal posttransplant (adjusting to ongoing dependence on medications, in both states of illness and health, unfulfilled expectations); and preserving graft survival (maintaining the ability to participate in life, avoiding rejection, enacting a social responsibility of giving back). Transplant recipients take medications to preserve graft function, but dependence on medications jeopardizes their sense of normality. Interventions supporting the adaptation to medicine-taking and addressing treatment burdens may improve patient satisfaction and capacities to take medications for improved outcomes.
器官移植受者的服药是一项复杂且普遍存在的任务，对治疗结果有重大影响。本研究旨在描述成年实体器官移植受者服药的观点和经历。检索电子数据库至2020年7月，并采用主题综合法分析数据。从119项研究（n = 2901）中，我们确定了六个主题：对身份和抱负的威胁（自我形象受损、限制目标和角色、失去经济独立）；在不确定性和不信任中摸索（缺乏切实/可感知的益处、对副作用没有准备、决策时孤立无援）；减轻治疗负担（建立并掌握常规、对抗副作用、为意外情况做准备）；获得并寻求信心（知识清晰、通过集体经历获得安心、关注未来前景）；重新适应移植后的新常态（适应对药物的持续依赖，无论疾病还是健康状态，期望未实现）；以及维持移植物存活（保持参与生活的能力、避免排斥、履行回馈的社会责任）。移植受者服药以维持移植物功能，但对药物的依赖危及他们的正常感。支持适应服药和解决治疗负担的干预措施可能会提高患者满意度以及服药能力，从而改善治疗结果。
