Department of Nursing, Capital Medical University Youan Hospital, Capital Medical University, Beijing, China.
Ann Transplant. 2024 Nov 26;29:e944320. doi: 10.12659/AOT.944320.
BACKGROUND Evidence on psychological factors associated with post-transplant post-traumatic stress disorder (PTSD) in liver transplantation (LT) patients is limited. Identifying the psychological factors associated with post-transplant PTSD would help to understand the symptoms of PTSD and take preventive measures. The aim of this study was to investigate factors influencing stress disorders in Intensive Care Unit (ICU) patients 1 year after LT. MATERIAL AND METHODS We assessed data from 184 LT patients at our hospital between January 2020 and December 2022. According to the PCL-C score, the patients were divided into the PTSD group (score ≤37) and the non-PTSD group (score >37). The demographic data, clinical data, the pain visual analogue scale (VAS), the anxiety and depression scale (HADS), and the psychological resilience scale (CD-RISC score) were compared between the 2 groups. Pearson correlation analysis was used to analyze the correlation between PCL-C and VAS, HADS, and CD-RISC, and logistic regression was used to analyze the factors influencing PTSD. SPSS 23.0 software was used for statistical analysis. RESULTS The average age of the 184 participants was 53.17 years (±3.47) and 66.85% of the subjects were male. The prevalence rate of post-transplant PTSD was 22.83% and the total score on the PCL-C scale was 32.47±7.81. Pearson correlation analysis showed that PCL-C score was positively correlated with VAS (r=0.312, P=0.012) and HADS (r=0.412, P<0.001), and negatively correlated with CD-RISC (r=-0.468, P<0.001). Logistic regression analysis showed that the symptom of post-transplant PTSD was significantly associated with higher VAS (OR=1.058, P=0.007) and HADS (OR=1.885, P<0.001) scores and lower CD-RISC (OR=2.213, P<0.001) score, which indicated that higher VAS and HAD scores were risk factors that contributed to PTSD and lower CD-RISC was a protective factor against PTSD. CONCLUSIONS We found that pain, anxiety, depression, and resilience were associated with symptoms of PTSD in LT patients in the ICU. Nursing staff should seek to relieve their patients' pain and assure provision of targeted health education and personalized psychological counseling to reduce the risk of PTSD after LT.
有关肝移植（LT）患者移植后创伤后应激障碍（PTSD）相关心理因素的证据有限。确定与移植后 PTSD 相关的心理因素将有助于了解 PTSD 的症状并采取预防措施。本研究旨在探讨影响 ICU 患者 LT 后 1 年应激障碍的因素。
我们评估了 2020 年 1 月至 2022 年 12 月我院 184 例 LT 患者的数据。根据 PCL-C 评分，将患者分为 PTSD 组（评分≤37）和非 PTSD 组（评分>37）。比较两组患者的人口统计学资料、临床资料、疼痛视觉模拟评分（VAS）、焦虑抑郁量表（HADS）和心理弹性量表（CD-RISC 评分）。采用 Pearson 相关分析 PCL-C 与 VAS、HADS 和 CD-RISC 的相关性，采用 logistic 回归分析 PTSD 的影响因素。采用 SPSS 23.0 软件进行统计学分析。
184 名参与者的平均年龄为 53.17 岁（±3.47），其中 66.85%为男性。移植后 PTSD 的患病率为 22.83%，PCL-C 量表总分为 32.47±7.81。Pearson 相关分析显示，PCL-C 评分与 VAS（r=0.312，P=0.012）和 HADS（r=0.412，P<0.001）呈正相关，与 CD-RISC（r=-0.468，P<0.001）呈负相关。Logistic 回归分析显示，移植后 PTSD 症状与较高的 VAS（OR=1.058，P=0.007）和 HADS（OR=1.885，P<0.001）评分和较低的 CD-RISC（OR=2.213，P<0.001）评分显著相关，这表明较高的 VAS 和 HADS 评分是 PTSD 的危险因素，而较低的 CD-RISC 评分是 PTSD 的保护因素。
我们发现疼痛、焦虑、抑郁和恢复力与 LT 患者 ICU 中 PTSD 症状有关。护理人员应努力减轻患者的疼痛，并提供有针对性的健康教育和个性化心理咨询，以降低 LT 后 PTSD 的风险。
