Grady K L, Jalowiec A, White-Williams C
Department of Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill. 60612-3824, USA.
Am J Crit Care. 1998 Mar;7(2):106-16.
Quality of life is an important healthcare outcome to study. Quality of life after heart transplantation has not been compared with indicators of severity of illness before heart transplantation.
To compare differences in quality of life 6 months after heart transplantation with two preoperative indicators of severity of illness: New York Heart Association classification and United Network for Organ Sharing status.
Data were collected from a nonrandom sample of 219 adult patients who had received a heart transplant 6 months earlier. Patients were divided into groups on the basis of their New York Heart Association classification and United Network for Organ Sharing status immediately before transplantation. Instruments used were the Heart Transplant Symptom Checklist, Heart Transplant Stressor Scale, Rating Question Form, Quality of Life Index, Sickness Impact Profile, and Jalowiec Coping Scale. Data were analyzed with descriptive statistics, chi-square tests, and independent t tests.
Quality of life 6 months after receiving a heart transplant varied with severity of illness before transplantation. These differences in quality of life were in the following domains: physical and occupational function, psychological state, and social interaction. Six months after receiving a heart transplant, patients who were more severely ill before transplantation were less satisfied with their lives, perceived that they were not doing as well, experienced more family-related stress, and used more negative coping strategies than did patients who were less severely ill preoperatively.
These findings indicate the need for further study of quality of life in the transplant recipients who are the most critically ill in intensive care settings before surgery, to develop interventions to improve recipients' quality of life, and to evaluate effectiveness of those interventions longitudinally.
生活质量是一个值得研究的重要医疗保健结果。心脏移植后的生活质量尚未与心脏移植前的疾病严重程度指标进行比较。
比较心脏移植6个月后的生活质量与两个术前疾病严重程度指标的差异：纽约心脏协会分级和器官共享联合网络状态。
从219名6个月前接受心脏移植的成年患者的非随机样本中收集数据。根据患者移植前的纽约心脏协会分级和器官共享联合网络状态将其分组。使用的工具包括心脏移植症状清单、心脏移植压力源量表、评分问卷、生活质量指数、疾病影响概况和贾洛维茨应对量表。数据采用描述性统计、卡方检验和独立t检验进行分析。
心脏移植6个月后的生活质量因移植前疾病的严重程度而异。这些生活质量差异体现在以下几个方面：身体和职业功能、心理状态和社会互动。心脏移植6个月后，移植前病情较重的患者对生活的满意度较低，认为自己做得不够好，经历了更多与家庭相关的压力，并且比术前病情较轻的患者使用了更多的消极应对策略。
这些发现表明，需要对术前重症监护病房中病情最严重的移植受者的生活质量进行进一步研究，以制定改善受者生活质量的干预措施，并纵向评估这些干预措施的有效性。
