Psychosocial vulnerability, physical symptoms and physical impairment after lung and heart-lung transplantation
Psychosocial vulnerability, physical symptoms and physical impairment after lung and heart-lung transplantation
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DOI：
10.1016/s1053-2498(02)01227-5
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发表时间：
2003-11-01
影响因子：
8.9
通讯作者：
Iacono, A
中科院分区：
文献类型：
--
作者：
Dabbs, AD;Dew, MA;Iacono, A
背景：许多肺和心肺移植受者经历了令人痛苦的身体症状和身体损伤水平升高。虽然移植后并发症和继发性疾病可能在很大程度上导致这些健康限制，但患者的心理社会健康也可能影响这些限制。我们研究的贡献，心理社会变量的患者的经验，身体症状和身体impairment.Methods：该研究包括一个横截面样本的50例（36肺，14心肺）在2和17个月之间移植后。他们接受了采访，以评估身体症状，目前的身体损害和心理健康的心理健康，掌握感和，应对领域。医疗记录审查确定存在医疗并发症和继发性疾病的同时，采访。描述性分析检查了症状的范围和经历的身体损害的程度。双变量分析和多元线性回归研究关键variables.Results之间的关系：平均身体症状和身体损害的水平达到或超过其他移植样本中报告的水平。抑郁和焦虑症状升高，掌握感低，以及并发症的存在都与身体症状和身体损伤水平的增加有关。当并发症的影响得到控制，收件人与升高的心理困扰仍然显着更有可能报告更多的身体症状和更高的身体损害level.Conclusions：患者的身体健康状况可能会受到许多因素的影响。在某种程度上，心理困扰增加了感知到的身体限制的可能性，及时识别和治疗的困扰可能有助于最大限度地提高肺和心肺移植后的生活质量。
Background: Many lung and heart-lung transplant recipients experience distressing physical symptoms and elevated physical impairment levels. Although post-transplant complications and secondary illnesses may largely account for these health limitations, patients' psychosocial well-being may influence them as well. We examined the contribution of psychosocial variables to patients' experience of physical symptoms and physical impairment.Methods: The study consisted of a cross-sectional sample of 50 patients (36 lung, 14 heart-lung) at between 2 and 17 months post-transplant. They were interviewed to assess physical symptoms, current physical impairment and psychosocial well-being in the areas of mental health, sense of mastery and,coping. Medical record reviews established the presence of medical complications and secondary illnesses concurrent with the interviews. Descriptive analyses examined the range of symptoms and levels of physical impairment experienced. Bivariate analyses and multivariate linear regression examined relationships between key variables.Results: Average number of physical symptoms and level of physical impairment met or exceeded levels reported in other transplant samples. Elevated depressive and anxiety symptoms, a low sense of mastery, and the presence of concurrent medical complications were each associated with increased number of physical symptoms and physical impairment level. When the impact of concurrent medical complications was controlled, recipients with elevated psychologic distress remained significantly more likely to report more physical symptoms and higher physical impairment levels.Conclusions: Patients' physical health status may be influenced by many factors. To the extent that psychologic distress increases the likelihood of perceived physical limitations, timely identification and treatment of distress may help to maximize quality of life after lung and heart-lung transplantation.