Adherence and health-related quality of life in adolescent liver transplant recipients
Adherence and health-related quality of life in adolescent liver transplant recipients
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DOI：
10.1111/j.1399-3046.2008.00901.x
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发表时间：
2008-05-01
影响因子：
1.3
通讯作者：
Lopez, M. James
中科院分区：
文献类型：
--
作者：
Fredericks, Emily M.;Magee, John C.;Lopez, M. James
青春期是不遵守移植后医疗方案的特别高风险时期。仍然缺乏研究调查相关因素的不遵守青少年LT收件人。本研究实证评估青少年接受LT的依从性和HRQOL之间的关系。参与者包括25名青少年（平均= 15.1岁，范围12-17.9）和他们的父母/监护人。使用多个指标评估依从性，包括临床医生进行的访谈，门诊就诊率，s.d.他克莫司的血液浓度采用自我报告和父母代理报告对经过充分验证的评估措施进行HRQOL检查。结果表明，76%的参与者不遵守至少一项措施的遵守，HRQOL显着低于正常数据的健康儿童。他克莫司与身体、学校和社会功能领域的HRQOL差显著相关。非遵守青少年报告较差的健康观念，自尊，心理健康，家庭凝聚力，和更多的限制，在社会和学校活动有关的身体，情绪和行为问题。这些结果表明，经验为基础的评估HRQOL可能有助于确定那些在行为，情绪和学校的困难，以及不遵守的风险最高。他克莫司s.d.的检验。还有助于识别可能从干预中受益的患者，以促进依从性和HRQOL。前瞻性研究是必要的，以进一步确定HRQOL的依从性和长期健康结果的影响，以进一步指导临床干预。
Adolescence is a particularly high-risk period for non-adherence with post-transplant medical regimens. There remains a lack of research investigating factors related to non-adherence in adolescent LT recipients. The present study empirically assessed the relationship between adherence and HRQOL in adolescent LT recipients. Participants included 25 adolescents (mean = 15.1 yr, range 12-17.9) and their parent/guardian(s). Adherence was assessed using multiple indices including clinician-conducted interviews, rate of clinic attendance, and s.d. of consecutive tacrolimus blood levels. HRQOL was examined using self-report and parent-proxy report on well-validated assessment measures. Results indicated that 76% of participants were non-adherent on at least one measure of adherence, and HRQOL was significantly lower than normative data for healthy children. Tacrolimus s.d. were significant related to poor HRQOL across domains of physical, school, and social functioning. Non-adherent adolescents reported poorer health perceptions, self-esteem, mental health, family cohesion, and more limitations in social and school activities related to physical, emotional, and behavioral problems. These results suggest that empirically based assessment of HRQOL may help identify those at highest risk for behavior, emotional and school difficulties, as well as non-adherence. The examination of tacrolimus s.d. may also help identify patients who may benefit from intervention to promote adherence and HRQOL. Prospective investigations are necessary to further identify the impact of HRQOL on adherence and long-term health outcomes to further guide clinical intervention.