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新冠疫情对肝移植受者生活质量及心理社会困境的影响。

Impact of covid-19 pandemic on quality of life and psychosocial difficulties among liver transplant recipients.

作者信息

Choudhury Ashok, Varshney Mohit, Sahoo Bishnupriya, Pamecha Viniyendra, Sinha Piyush, Patil Nilesh Sadashiv, Mohapatra Nihar, Sharma Vibhuti, Kumar Raman

机构信息

Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India.

Department of Psychiatry, Institute of Liver and Biliary Sciences, New Delhi, India.

出版信息

J Family Med Prim Care. 2022 Feb;11(2):744-750. doi: 10.4103/jfmpc.jfmpc_1798_21. Epub 2022 Feb 16.

Abstract

BACKGROUND

The first wave of the COVID-19 pandemic affected health in all domains i.e., physical, mental, and social aspects. Liver transplant (LT) recipients faced a multitude of challenges during the first wave of lockdown. The aim was to identify the psychosocial difficulties and quality of life during the first year of the pandemic.

METHODS

A cross-sectional survey was conducted on LT recipients with a predefined structured questionnaire that included clinical, COVID-19 anxiety scale, and Post-Transplant Quality of life questionnaire (pLTQ).

RESULTS

A total of 109 patients were studied; with a mean age of 50.5 ± 11.1 years, with a median post-transplant follow-up of 52.4 months and a live donor transplant in the majority (79.8%). Almost all (99.1%) could come to the hospital for regular follow-up, prior to the pandemic. But during the first wave only 57% could maintain planned hospital visits and about 88% could not pursue their regular activities, and 39% missed their routine exercise because of imposed restrictions. Similarly, financial implications were responsible for 4% defaulting from treatment; while 7.3% managed by curtailing supportive drugs (on their own) leading to deranged liver tests in 4.6%; requiring immediate attention. The psychosocial difficulties raised the stress of pandemic (median score 18), and impacted quality of life (mean total pLTQ score 4.7 ± 0.9).

CONCLUSIONS

For LT recipients, the first wave of COVID-19 pandemic affected their physical, mental, financial, and social wellbeing; in addition to the disease itself. Awareness, psychosocial support, and comprehensive care are some unmet needs for this special group; especially when it is expected that subsequent waves may continue to occur.

摘要

背景

新冠疫情的第一波冲击影响了健康的各个领域,即身体、心理和社会层面。肝移植(LT)受者在第一波封锁期间面临诸多挑战。本研究旨在确定疫情第一年期间受者的心理社会困难及生活质量。

方法

采用预先定义的结构化问卷对LT受者进行横断面调查,问卷包括临床情况、新冠焦虑量表和移植后生活质量问卷(pLTQ)。

结果

共研究了109例患者;平均年龄50.5±11.1岁,移植后中位随访时间为52.4个月,大多数(79.8%)为活体供肝移植。在疫情之前,几乎所有患者(99.1%)都能来医院进行定期随访。但在第一波疫情期间,只有57%的患者能够维持计划中的医院就诊,约88%的患者无法进行日常活动,39%的患者因实施的限制措施而中断了日常锻炼。同样,经济问题导致4%的患者未能接受治疗;7.3%的患者自行减少支持性药物用量,导致4.6%的患者肝功能检查紊乱,需要立即关注。心理社会困难增加了疫情带来的压力(中位数得分18),并影响了生活质量(pLTQ总平均分4.7±0.9)。

结论

对于LT受者而言,新冠疫情的第一波冲击除了影响疾病本身外,还影响了他们的身体、心理、经济和社会福祉。提高认识、提供心理社会支持和全面护理是这一特殊群体尚未满足的一些需求;特别是考虑到预计后续可能还会出现疫情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0927/8963630/20d179a53025/JFMPC-11-744-g001.jpg

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