Assessment and management of psychosocial challenges in pediatric liver transplantation.
Assessment and management of psychosocial challenges in pediatric liver transplantation.
复制标题
儿科肝移植中心理社会挑战的评估和管理。
DOI：
10.1002/lt.21582
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Shemesh,Eyal
中科院分区：
文献类型：
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作者：
Shemesh,Eyal
肝移植为儿童和青少年提供了生存的可能性和可接受的生活质量，否则他们可能无法生存。然而，尽管患者的健康和前景有了显著改善，肝移植并不是完全治愈。相反，病人是在用一种危及生命的、有时是急性的疾病来换取一种慢性疾病。移植幸存者面临着其他慢性病幸存者所面临的许多挑战。患者需要遵守药物治疗方案和临床随访计划。他们需要避免某些情况（例如，接触患有病毒性疾病的人）。此外，他们一直生活在被排斥的威胁之下，在某些情况下，他们的疾病还会复发。这些问题对儿童来说可能比成人更重要。孩子们预计将在移植手术中度过一生。此外，与成人相比，儿童在完成同伴社会化和认知能力等发展任务方面面临的挑战更大。有大量的文献与慢性病儿童面临的挑战有关，在这里不可能进行总结。它也不会特别原创，因为已经存在关于儿科适应医学疾病的优秀文本。2-4因此，我决定不提供对心理社会挑战的一般性回顾，而是描述那些相对特定于移植情况的挑战。
Liver transplantation offers the potential of survival and acceptable quality of life1 to children and adolescents who might otherwise not be able to live. However, despite the dramatic improvement in patients’ health as well as outlook, liver transplantation is not a complete cure. Rather, the patient is trading a life-threatening, sometimes acute illness for a chronic one. The transplant survivor faces many challenges that are faced by other survivors of chronic illnesses. Patients need to adhere to a medication regimen and clinic follow-up schedules. They need to avoid certain situations (for example, exposure to a person who has a viral illness). Moreover, they live under the constant threat of a rejection or, in some cases, a relapse of their disease. These issues are perhaps even more important in children than adults. Children are expected to spend a full life span with their transplants. Also, children, more so than adults, face challenges related to the achievement of developmental tasks such as peer socialization and cognitive competency. There is a vast literature related to the challenges facing chronically ill children, and it would be impossible to summarize it here. It would also not be especially original, as excellent texts already exist on the subject of pediatric adjustment to medical illness. 2-4 Rather than providing a generic review of psychosocial challenges, I have decided therefore to describe the ones that are fairly specific to the transplant situation.