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单中心 8 例面部移植受者长期心理健康结局的更新。

Update on long-term mental health outcomes in eight face transplant recipients from a single center.

机构信息

Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.

University of Boston, Boston, MA, USA.

出版信息

Int J Psychiatry Med. 2024 Sep;59(5):583-594. doi: 10.1177/00912174231225764. Epub 2023 Dec 28.

Abstract

OBJECTIVE

Face transplantation is a groundbreaking and complex surgical intervention offering profound physical and psychological benefits to patients with severe facial disfigurements. This report provides an update on the long-term psychosocial outcome of eight face transplant recipients.

METHOD

All transplant recipients were initially transplanted at Brigham and Women´s Hospital (Boston, USA) between 2011 and 2020 and seen as outpatient patients at Yale New Haven Hospital (New Haven, USA). A mixed-methods approach was used to assess the psychological and social well-being of these patients. The Short-Form 12, Brief-COPE, EQ-VAS and CES-D were administered between October 2022 and October 2023.

RESULTS

Older age of face transplant recipients was significantly and positively associated with better mental health and increased use of both emotional and instrumental support (Brief-COPE). The initial enhancement in patients' self-reported quality of life, as assessed by the EQVAS, declined on the EQ-VAS score at the last follow-up. Similarly, an increase in depression score was observed (CES-D score) up through the last follow-up assessment. Both of the latter results, however, did not reach statistical significance.

CONCLUSIONS

These results underscore the importance of ongoing psychological support throughout the long-term journey of recovery for face transplant recipients. These findings emphasize the need for a comprehensive, patient-centered approach that also addresses the complex psychological dimensions and contributes to our understanding of the mental health dynamics involved in face transplantation, stressing the need for guidelines and continued research in this evolving field.

摘要

目的

面部移植是一项开创性的复杂手术,为严重面部畸形的患者带来了深远的身体和心理益处。本报告介绍了 8 名面部移植受者的长期社会心理结果的最新情况。

方法

所有移植受者最初均于 2011 年至 2020 年在布里格姆妇女医院(美国波士顿)接受移植,并在耶鲁纽黑文医院(美国纽黑文)作为门诊患者接受随访。采用混合方法评估这些患者的心理和社会幸福感。在 2022 年 10 月至 2023 年 10 月期间,采用简明健康调查量表 12 项简表(SF-12)、Brief-COPE、EQ-VAS 和 CES-D 进行评估。

结果

面部移植受者年龄较大与心理健康状况较好以及情绪支持和工具性支持的使用增加显著相关(Brief-COPE)。最初,患者自我报告的生活质量通过 EQ-VAS 评估得到了提高,但在最后一次随访时 EQ-VAS 评分有所下降。同样,抑郁评分也有所增加(CES-D 评分),直到最后一次随访评估。然而,后两个结果均未达到统计学意义。

结论

这些结果强调了在面部移植受者长期康复过程中提供持续心理支持的重要性。这些发现强调了需要一种全面、以患者为中心的方法,该方法还需要解决复杂的心理维度,并有助于我们了解面部移植所涉及的心理健康动态,强调了在这个不断发展的领域中制定指南和持续研究的必要性。

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