Cohen L, Littlefield C, Kelly P, Maurer J, Abbey S
Department of Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston 77030-4095, USA.
Chest. 1998 Mar;113(3):633-44. doi: 10.1378/chest.113.3.633.
Few studies have examined predictors of quality of life and adjustment after lung transplantation. This study determined whether pretransplant psychological measures predicted physical health, quality of life, and overall adjustment posttransplant. Cross-sectional analyses also examined differences in adjustment and quality of life for lung transplant candidates and recipients.
Seventeen transplant candidates and 60 transplant recipients completed questionnaires measuring adjustment and quality of life. In addition, we examined archival data on 107 transplant candidates who had received pretransplant psychological assessments, and posttransplant physical health status data were collected on these patients. Of the 107 patients who provided a pretransplant psychological assessment, 32 completed the questionnaires measuring posttransplant adjustment and quality of life.
University medical center transplant service.
Cross-sectional analyses indicated significantly better adjustment and quality of life posttransplant. Pretransplant psychological variables were not associated with measures of posttransplant physical health. Hierarchical multiple regression analyses found that pretransplant anxiety and psychopathology predicted posttransplant adjustment (beta's ranging from 0.32 to 0.68) and greater pretransplant anxiety also predicted worse posttransplant quality of life (beta's ranging from 0.29 to 0.62). Subjective sleep disturbances were associated with poorer adjustment and quality of life (beta's ranging from 0.36 to 0.75), and were found to mediate the relationship between presurgical anxiety and posttransplant adjustment and quality of life.
This study found that psychological status pretransplant predicted adjustment and quality of life posttransplant. Moreover, increased anxiety levels pretransplant predicted subsequent subjective sleep disturbances, which were, in turn, associated with poorer adjustment and quality of life. The benefits of pretransplant stress management interventions are discussed.
很少有研究探讨肺移植后生活质量及适应情况的预测因素。本研究旨在确定移植前的心理测量指标是否能预测移植后的身体健康、生活质量及整体适应情况。横断面分析还考察了肺移植候选者和接受者在适应情况和生活质量方面的差异。
17名移植候选者和60名移植接受者完成了测量适应情况和生活质量的问卷。此外，我们研究了107名接受过移植前心理评估的移植候选者的档案数据，并收集了这些患者移植后的身体健康状况数据。在提供了移植前心理评估的107名患者中，32名完成了测量移植后适应情况和生活质量的问卷。
大学医学中心移植科。
横断面分析表明移植后适应情况和生活质量明显更好。移植前心理变量与移植后身体健康指标无关。分层多元回归分析发现，移植前焦虑和精神病理学可预测移植后适应情况（β值范围为0.32至0.68），移植前焦虑程度越高也预示着移植后生活质量越差（β值范围为0.29至0.62）。主观睡眠障碍与较差的适应情况和生活质量相关（β值范围为0.36至0.75），并被发现介导了术前焦虑与移植后适应情况及生活质量之间的关系。
本研究发现移植前心理状态可预测移植后适应情况和生活质量。此外，移植前焦虑水平升高预示着随后会出现主观睡眠障碍，而主观睡眠障碍又与较差的适应情况和生活质量相关。文中讨论了移植前压力管理干预措施的益处。
