肾移植供者术后生活质量和心理健康状况及其影响因素的研究

发布时间：2018-05-23 06:48

本文选题：活体肾移植 + 生活质量　；参考：《中南大学》2010年硕士论文

【摘要】： 目的：1.描述肾移植供者术后生活质量和心理健康现状；2.分析影响供者术后生活质量和心理健康的相关因素。为进一步预测肾移植供者术后生活质量、心理健康、实施干预措施提供依据和参考。方法：采用SF-36简明健康量表、抑郁自评量表(SDS)、焦虑自评量表(SAS)和社会支持评定量表(SSRS),对103例肾移植供者进行问卷调查。将肾移植供肾者SF-36简明健康量表得分、SDS得分、SAS得分与正常参照人群的参考值进行比较,以了解肾移植供者生活质量和心理健康现状。然后采用Pearson和Spearman相关分析、多元回归分析及病例对照研究的方法分析影响肾移植供者生活质量和心理健康的因素。结果：1.与正常人群相比肾移植供者术后生活质量8个维度中情感职能、精神状态、活力和健康总评价分值均高于常模(P0.05)；心理健康状况和社会支持明显好于正常人群(P0.05)。 2.相关分析显示：年龄与生活质量8个维度中的生理功能、生理职能、情感职能、社会功能、疼痛、活力、精神状态均呈负相关(P0.05),提示老龄供者生活质量较差；性别与生理功能、情感职能、活力和健康总评价呈负相关(P0.05),提示男性供者生理状况、心理健康较好；供受者关系与生活质量的8个维度均呈负相关(P0.05),提示关系越密切生活质量越差；文化水平与生理功能、生理职能、社会功能、疼痛、活力、精神状态及健康总评价均呈正相关(P0.05),提示文化程度较高的供者身心状况较好；婚姻与健康总评价、生理职能、活力呈负相关(P0.05),提示未婚供者总体健康较好；术后时间与健康总评价和生理职能呈正相关(P0.05),提示术后时间越久健康状况越好；经济状况与生理功能、生理职能、疼痛呈正相关(P0.05),提示经济状况较好的供者机体功能和职能恢复较好；抑郁自评得分(SDS)和焦虑自评得分(SAS)与生活质量8个维度均呈负性相关(P0.05),提示有焦虑和抑郁情绪的供者生活质量较差；社会支持度、主观支持得分、社会支持利用度与供者术后生活质量的8个维度均呈正相关(P0.05),提示社会支持越高的供者生活质量越好。年龄、供受者关系与抑郁、焦虑得分呈正相关(P0.05),提示老龄、关系密切的供者心理健康较差；婚姻、性别与焦虑得分呈正相关(P0.05),提示已婚、女性供者易焦虑；经济状况、文化程度、社会支持与抑郁、焦虑得分呈负相关(P0.05),提示社会经济状况较好、社会支持较高的供者心理健康状况较好。性别与社会支持客观得分呈负相关(P0.05),提示男性的社会支持客观得分较高；供受者关系与社会支持度、社会支持客观得分、社会支持主观得分、社会支持利用度均呈负性相关(P0.05),提示关系越密切社会支持越差；文化水平与社会支持利用度呈正相关(P0.05),文化程度越高的供者社会支持利用度越高。 3.多元回归显示：供者术后心理健康状况(尤其是焦虑情绪),以及社会支持(尤其是主观得分和利用度)是生活质量及心理健康各个方面最重要的影响因素；供者术后抑郁、焦虑得分主要受社会支持和供受关系的影响；供受者关系是影响供者术后社会支持的最大因素。结论：1.在我国,肾移植供者主要来源于农村、老龄、女性、低文化水平、低经济水平、供受关系密切的亲属；且这部分供者生活质量和心理健康状况相对较差。 2.可能影响供者心理健康状况的社会生活事件强弱依次是：受者的身体健康状况、受者的家庭经济问题、肾移植术后移植肾功能情况、供者自身家庭经济状况、供者自身身体健康状况和供肾摘取术后孤立肾对于未来生活和工作的影响。 3.肾移植供者术后生活质量、心理健康、社会支持均好于普通人群。 4.影响供者术后生活质量的因素很多,主要受心理健康状况(尤其是焦虑情绪),以及社会支持(尤其是主观得分和利用度)的影响。 5.供者术后心理健康主要受社会支持和供受关系的影响。
[Abstract]:Objective: 1. to describe the quality of life and mental health of donors after renal transplantation; 2. to analyze the related factors affecting the quality of life and mental health of the donors after operation, and to provide the basis and reference for further prediction of the quality of life, mental health and intervention measures for the recipients of renal transplantation.
Methods: the SF-36 simple health scale, the self rating Depression Scale (SDS), the self rating Anxiety Scale (SAS) and the social support rating scale (SSRS) were used to investigate 103 renal transplant donors. The score of the SF-36 concise health scale, the SDS score, the SAS score and the reference value of the normal reference group were compared in order to understand the renal transplantation. The quality of life and the status of mental health of the donors were analyzed by Pearson and Spearman correlation analysis, multiple regression analysis and case control study to analyze the factors affecting the quality of life and mental health of donors in renal transplantation.
Results: 1. the total scores of emotional function, mental state, vitality and health were higher than those of normal model (P0.05) in 8 dimensions of life quality after renal transplantation. The mental health status and social support were better than those of normal people (P0.05).
2. the correlation analysis showed that age and quality of life were negatively correlated with physiological function, physiological function, emotional function, social function, pain, vitality and mental state (P0.05), suggesting that the quality of life of older donors was poor, and the total evaluation of gender and physiological function, emotional function, vitality and health was negatively correlated (P0.05), suggesting male donors. The physiological status and mental health were better; the 8 dimensions of the donor relationship and the quality of life were negatively correlated (P0.05), suggesting that the closer the relationship was, the worse the quality of life was, and the cultural level was positively correlated with physiological function, physiological function, social function, pain, vitality, mental state and health assessment price (P0.05), suggesting a higher level of cultural level. The overall evaluation of marriage and health, physiological function and vitality were negatively correlated (P0.05), suggesting that the overall health of the unmarried donors was better, and the postoperative time was positively correlated with the overall health evaluation and physiological function (P0.05), suggesting that the better the health status was, the better the health status was, the economic status was positively related to physiological function, physiological function and pain (P0.05). The results showed that the function and function of the donors with better economic status were better, the self rating depression score (SDS) and the self rating anxiety score (SAS) were negatively correlated with the 8 dimensions of quality of life (P0.05), suggesting that the quality of life of the donors with anxiety and depression was poor, social support, subjective support score, social support utilization and donor operation. The 8 dimensions of quality of life were positively correlated (P0.05), suggesting that the higher the social support, the better the quality of life of the donor.
Age, the relationship between the donor and the donor was positively correlated with depression and anxiety score (P0.05), suggesting that the elderly and the closely related donors were poor in mental health; marriage, gender and anxiety score had a positive correlation (P0.05), suggesting that married, female donors were prone to anxiety; economic status, educational level, social support and depression, and anxiety scores negatively correlated (P0.05), suggesting social classics. The mental health status of donors with better social support was better.
The objective score of gender and social support was negatively correlated (P0.05), suggesting that the objective score of social support was higher; the relationship and social support of the recipient, the objective score of social support, the subjective score of social support and the social support utilization were negatively correlated (P0.05), the closer the relationship was, the worse the social support was, and the cultural level and social support. The degree of utilization was positively correlated (P0.05), and the higher the degree of social support was, the higher the social support utilization was.
3. multiple regression showed that the psychological health status (especially anxiety) of the donor, and social support (especially the subjective score and utilization) were the most important factors in the quality of life and all aspects of mental health; the post operation depression and anxiety score were mainly influenced by the social support and the influence of the donor relationship; the donor relationship was the shadow. The biggest factor in social support for the donors after the operation.
Conclusion: 1. in China, the donor of renal transplantation mainly comes from rural, aged, female, low cultural and low economic level, which is closely related to relatives, and the quality of life and mental health of this part of the donor is relatively poor.
2. the social life events that may affect the mental health of the donor are in turn: the health of the recipients, the family economic problems of the recipients, the function of the renal transplantation after renal transplantation, the family economic status of the donors, the health of the donors, and the influence of the solitary kidney after the removal of the kidney on the future life and work.
3. the quality of life, mental health and social support of kidney transplant recipients were better than those of the general population.
4. there are many factors affecting the quality of life of the donor, mainly affected by mental health (especially anxiety), and social support (especially subjective score and utilization).
5. the mental health of donors was mainly affected by social support and relationship between donors and recipients.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R699;R395

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