Changes in quality of life (QoL) and other patient-reported outcome measures (PROMs) in living-donor and deceased-donor kidney transplant recipients and those awaiting transplantation in the UK ATTOM programme: a longitudinal cohort questionnaire survey with additional qualitative interviews.
Changes in quality of life (QoL) and other patient-reported outcome measures (PROMs) in living-donor and deceased-donor kidney transplant recipients and those awaiting transplantation in the UK ATTOM programme: a longitudinal cohort questionnaire survey with additional qualitative interviews.
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DOI：
10.1136/bmjopen-2020-047263
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发表时间：
2021-04-14
期刊：
影响因子：
2.9
通讯作者：
Bradley C
中科院分区：
文献类型：
--
作者：
Gibbons A;Bayfield J;Cinnirella M;Draper H;Johnson RJ;Oniscu GC;Ravanan R;Tomson C;Roderick P;Metcalfe W;Forsythe JLR;Dudley C;Watson CJE;Bradley JA;Bradley C
研究肾移植受者和等待移植者的生活质量（QoL）和其他患者报告的结局指标（PROM）。纵向队列问卷调查和定性半结构化访谈，采用主题分析与务实的方法。在两个时间点完成通用和疾病特异性PROM，并与英国范围内的参与者进行电话访谈。101例事件死亡供体（DD）和94例事件活体供体（LD）肾移植受者，以及165例来自18个英国中心的等待名单（WL）上的患者，招募到移植和移植结局指标（ATTOM）项目，在招募时（2011年11月至2013年3月）和1年随访时完成了PROM。在研究期间，165名WL患者中有41名接受了DD移植，26名接受了LD移植，最初作为WL患者完成了PROM，并在移植后1年再次完成。一个子样本的10 LD和10 DD收件人参加了定性半结构化访谈。LD接受者更年轻，有更多的教育资格，更经常在透析前接受移植。控制这些和其他因素，在移植后12个月的横断面分析表明，更好的生活质量，肾依赖性生活质量和治疗满意度LD比DD受体。与两个移植组相比，WL组的患者报告了更差的结果。然而，纵向分析（控制移植前差异）显示，LD和DD受者在移植前和移植后报告了相似的健康状况和肾依赖性QoL改善（p<0.01）。WL患者的健康状况恶化，但生活质量无变化。定性分析显示，移植受者的期望影响他们的恢复和移植的满意度。虽然横断面分析表明LD肾移植导致更好的生活质量和治疗满意度，但纵向评估显示两个移植组的PROM的生活质量改善相似，结局优于仍在等待名单中的患者。无论移植类型如何，临床医生都需要意识到，管理期望对于促进患者移植后的调整非常重要。
To examine quality of life (QoL) and other patient-reported outcome measures (PROMs) in kidney transplant recipients and those awaiting transplantation. Longitudinal cohort questionnaire surveys and qualitative semi-structured interviews using thematic analysis with a pragmatic approach. Completion of generic and disease-specific PROMs at two time points, and telephone interviews with participants UK-wide. 101 incident deceased-donor (DD) and 94 incident living-donor (LD) kidney transplant recipients, together with 165 patients on the waiting list (WL) from 18 UK centres recruited to the Access to Transplantation and Transplant Outcome Measures (ATTOM) programme completed PROMs at recruitment (November 2011 to March 2013) and 1 year follow-up. Forty-one of the 165 patients on the WL received a DD transplant and 26 received a LD transplant during the study period, completing PROMs initially as patients on the WL, and again 1 year post-transplant. A subsample of 10 LD and 10 DD recipients participated in qualitative semi-structured interviews. LD recipients were younger, had more educational qualifications and more often received a transplant before dialysis. Controlling for these and other factors, cross-sectional analyses at 12 months post-transplant suggested better QoL, renal-dependent QoL and treatment satisfaction for LD than DD recipients. Patients on the WL reported worse outcomes compared with both transplant groups. However, longitudinal analyses (controlling for pre-transplant differences) showed that LD and DD recipients reported similarly improved health status and renal-dependent QoL (p<0.01) pre-transplant to post-transplant. Patients on the WL had worsened health status but no change in QoL. Qualitative analyses revealed transplant recipients’ expectations influenced their recovery and satisfaction with transplant. While cross-sectional analyses suggested LD kidney transplantation leads to better QoL and treatment satisfaction, longitudinal assessment showed similar QoL improvements in PROMs for both transplant groups, with better outcomes than for those still wait-listed. Regardless of transplant type, clinicians need to be aware that managing expectations is important for facilitating patients’ adjustment post-transplant.
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影响因子：
0.9
作者：
Guimaraes, J.;Araujo, A. M.;Casal, M.
通讯作者：
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影响因子：
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