Health Psychology, Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, MMC 741, 420 Delaware Street, S.E, Minneapolis, MN, 55455, USA.
Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
J Clin Psychol Med Settings. 2022 Mar;29(1):168-184. doi: 10.1007/s10880-021-09792-2. Epub 2021 Jun 4.
Like patients with many chronic illnesses, ESRD patients experience psychological challenges with greater incidence of depression and reduced quality of life (QoL). A series of 139 transplant candidates' depression and QoL, and a subset of 82 candidates' medication adherence were monitored, revealing heterogenous patterns of depression and adherence and reduced QoL. Twenty-eight patients who received kidney transplants were re-evaluated 6 months post-transplant revealing mixed patterns. Mean depression and quantitated adherence decreased and QoL increased. Some patients improved whereas others declined in depression and adherence. Pre-transplant depression was negatively correlated with post-transplant adherence but positively correlated with post-transplant depression. Nevertheless, the ability to predict individuals' post-transplant adherence and depression, principal objectives of pre-transplant psychological evaluations, is limited. Consequently, it is important to provide periodic screening of ESRD patients for depression and adherence pre- and post-transplant as they reflect changing states, rather than static traits, with variable patterns across patients.
与许多慢性病患者一样，ESRD 患者经历心理挑战的发生率更高，抑郁发生率更高，生活质量（QoL）降低。对一系列 139 名移植候选者的抑郁和 QoL 以及 82 名候选者的药物依从性进行了监测，结果显示抑郁和依从性以及 QoL 呈异质模式。对 28 名接受肾移植的患者进行了移植后 6 个月的重新评估，结果显示混合模式。抑郁和定量药物依从性降低，QoL 增加。一些患者的抑郁和药物依从性有所改善，而另一些患者则有所下降。移植前的抑郁与移植后的药物依从性呈负相关，但与移植后的抑郁呈正相关。尽管如此，预测个体移植后药物依从性和抑郁的能力，即移植前心理评估的主要目标，是有限的。因此，重要的是在移植前和移植后定期筛查 ESRD 患者的抑郁和药物依从性，因为它们反映的是患者之间变化的状态，而不是静态特征，具有不同的模式。
