Harper R G, Chacko R C, Kotik-Harper D, Young J, Gotto J
Department of Psychiatry, Baylor College of Medicine, Houston, Texas 77030, USA.
Psychosom Med. 1998 Sep-Oct;60(5):563-9. doi: 10.1097/00006842-199809000-00009.
The purpose of this study was to explore the value of patient self-report assessment in heart transplant candidacy evaluation, utilizing the Millon Behavioral Health Inventory (MBHI). Patient's MBHI measures were related to important pretransplant patient characteristics and posttransplant measures of health behavior, medical morbidity, and mortality.
Ninety heart patients with end-stage cardiac disease completed the MBHI during pretransplant candidacy evaluations, and also were interviewed concerning their coping effectiveness, support resources, and compliance history. Postransplant follow-up of 61 living and 29 deceased patients included measures of survival time, postsurgical medical care, rejection and infection episodes, and nurse ratings of medication compliance and problematic interpersonal health behaviors.
The MBHI coping scales were found to significantly discriminate good and poor pretransplant compliance, and interview judgments of good and poor coping and support resources, with modest accuracy. The MBHI also was superior to these interview judgments in predicting posttransplant survival time and medical care used. Certain scales were also positively associated with physical parameters of pretransplant and posttransplant status.
Patient self-report with the MBHI can contribute to identification of patients at risk for a problematic outcome with transplant, by providing information pertinent to clinical decision making and outcome management analysis with this special population of cardiac patients.
本研究旨在利用米隆行为健康量表（MBHI）探索患者自我报告评估在心脏移植候选资格评估中的价值。患者的MBHI测量结果与移植前重要的患者特征以及移植后健康行为、医疗发病率和死亡率的测量结果相关。
90例终末期心脏病患者在移植前候选资格评估期间完成了MBHI，同时还接受了关于其应对效果、支持资源和依从史的访谈。对61例存活患者和29例死亡患者进行移植后随访，包括生存时间、术后医疗护理、排斥反应和感染发作的测量，以及护士对药物依从性和有问题的人际健康行为的评分。
发现MBHI应对量表能显著区分移植前依从性的好坏，以及应对和支持资源好坏的访谈判断，准确性一般。在预测移植后生存时间和所使用的医疗护理方面，MBHI也优于这些访谈判断。某些量表还与移植前和移植后状态的身体参数呈正相关。
通过使用MBHI进行患者自我报告，可为识别移植后可能出现问题结果的患者提供帮助，为针对这一特殊心脏病患者群体的临床决策和结果管理分析提供相关信息。
