Solid organ transplantation: Are there predictors for posttransplant noncompliance? A literature overview
Solid organ transplantation: Are there predictors for posttransplant noncompliance? A literature overview
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DOI：
10.1097/00007890-200009150-00001
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发表时间：
2000-09-15
期刊：
影响因子：
6.2
通讯作者：
Laederach-Hofmann, K
中科院分区：
文献类型：
--
作者：
Bunzel, B;Laederach-Hofmann, K
背景许多研究证实，不依从或依从性差是卫生保健中最大的问题之一，因为它导致资源和资金的浪费。本综述包括心脏，肝脏和肾脏移植的文献，重点是成人和儿科移植患者的心脏移植，并将以下变量作为术后依从性问题的潜在预测因素：人口统计学变量（年龄、婚姻状况、性别）心理变量（焦虑、否认）精神障碍（严重抑郁症、焦虑症和人格障碍）、社会支持差、移植前不依从、肥胖、药物滥用，和健康相关变量（与移植中心的距离、移植适应症、所需的移植前辅助装置）。本概述包括并讨论了截至1999年就这些专题进行的相关研究。最重要的结果见表“结果”。不幸的是，迄今为止，还没有任何系统和全面的文献综述器官移植患者不依从性的预测因素。对于器官移植，不依从性损害生活质量和寿命，因为它是移植排斥反应的主要风险因素，并且在最初恢复期后导致高达25%的死亡。因此，可以假设知情的移植患者是一个高度积极的群体，他们的依从性也同样高。然而，即使在心脏或肝脏移植中，移植物丢失意味着生命的丧失，也会发生不依从行为。为了最好地选择潜在的器官受体，如果在移植前就能识别出很可能表现出不依从行为的患者，那将是理想的。文献综述显示了术前心理社会筛查对移植后不依从性预测的必要性。
Background. Many studies confirm that noncompliance or poor compliance is one of the great problems in health care as it results in waste of resources and funds.Methods. This overview includes literature on heart, liver, and kidney transplants with emphasis on heart transplantation in adult and pediatric transplant patients and addresses the following variables as potential predictors of postoperative compliance problems: demographic variables (age, marital status, gender) psychological variables (anxiety, denial) psychiatric disorders (major depression, anxiety, and personality disorders), poor social support, pretransplant noncompliance, obesity, substance abuse, and health-related variables (distance from transplant center, indication for transplantation, required pretransplant assist device). Relevant studies on these topics that were conducted up to 1999 are included and discussed in this overview. The most important results are presented in tables,Results. Unfortunately, there has not been any systematic and comprehensive review of the literature on predictors of noncompliance in organ transplant patients so far. With organ transplantation noncompliance impairs both life quality and life span as it is a major risk factor for graft rejection episodes and is responsible for up to 25% of deaths after the initial recovery period. Therefore, it might be assumed that well-informed transplant patients are a highly motivated group whose compliance is just as high. This is not the case, However, even when graft loss means loss of life as in heart or liver transplantation, noncompliance occurs, To best select potential organ recipients, it would be ideal if patients who are very likely to show noncompliant behavior could be identified already before being transplanted,Conclusion. The literature overview shows the necessity of preoperative psychosocial screening regarding predictors for posttransplant noncompliance.