肝移植受者的心理弹性与生存质量的相关性研究

发布时间：2019-03-21 10:18

【摘要】：目的:本研究以接受原位肝移植手术(Orthotopic Liver Transplantion,OLP)术后患者为研究对象,主要了解其心理弹性水平及生存质量现状,探讨社会人口学资料及临床相关资料对肝移植受患者的心理弹性和生存质量的影响,并探讨肝移植受者的心理弹性与生存质量之间的关系,为肝移植受者的心理疏导及心理治疗提供理论依据,为提高肝移植受者生存质量寻找方法与途径。方法:本研究采用横断面调查研究,抽样方法为便利抽样,随机选择了从2015年7月至2016年11月在广州军区广州总医院门诊随诊和住院治疗并符合纳入标准和排除标准的肝移植术后患者进行问卷调查。问卷由三部分组成,分别为Connor和 Davidson 心理弹性量表(Connor-Davidson Resilience scale,CD-RISC)中文版、健康状况问卷(Short Form 36 Health Survey Questionnaire,SF-36)中文版及自制一般资料调查问卷。将收集到的数据结果录入excle表格进行整理,采用均数及标准差、构成比等对样本资料进行统计学描述;采用独立样本t检验将肝移植受者的心理弹性和生存质量分别与其对应常模比较;采用t检验、方差分析对人口学资料及临床相关资料对肝移植受者的心理弹性及生存质量的影响进行分析;肝移植受者心理弹性的影响因素采用多元逐步回归分析;肝移植受者的心理弹性与生存质量各因子采用pearson相关分析;心理弹性高低分组对生存质量的影响采用独立样本t检验。使用SPSS 21.0进行统计软件分析。当P0.05时,认为差异有统计学意义。结果:(1)研究显示,肝移植受者的心理弹性总分及各因子均低于中国常模,差异有统计学意义(P0.05);肝移植受者的生存质量八个方面得分均低于中国常模(P0.05)。(2)社会人口学资料及临床相关资料与肝移植受者心理弹性关系的研究结果显示:不同性别、年龄、婚姻状况、教育程度、宗教信仰、月收入情况、医保类型、原发病类型、移植年限、并发症者,其心理弹性水平存在差异(P0.05)。(3)对影响肝移植受者心理弹性的社会人口学因素及临床相关因素作多元逐步回归分析,结果显示性别、医疗类型、并发症因素收入以心理弹性为因变量的回归方程,三者共同解释了整体的的59.3%(P0.05),并且性别、医疗类型有显著正向影响,并发症有显著负向影响。(4)社会学资料及临床相关资料与肝移植受者躯体相关生存质量、生理相关生存质量关系的研究结果显示:不同性别、年龄、婚姻状况、教育程度、宗教信仰、月收入情况、医保类型、移植年限、并发症者,其心理弹性水平存在差异(P0.05);不同原发病类型在患者躯体相关生存质量存在差异(P0.05),在心理生存质量相关不存在差异(P0.05)。(5)肝移植受者的心理弹性得分与生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能以及精神健康成显著正相关(P0.05)。结论:(1)肝移植受者的心理弹性总体水平比较低,其中表现为乐观性最差;肝移植受者的生存质量水平较低。(2)肝移植受者的心理弹性受性别、年龄、婚姻状况、教育程度、收入情况、宗教信仰、社会支持、医保类型、原发病类型、移植年限、并发症等因素影响。其中,男性、年龄高、已婚、教育程度高、收入情况好、有宗教信仰、有医疗保险、原发病为肝癌、移植年限较长者的心理弹性水平较高。性别、医疗类型、并发症因素为影响患者心理弹性的重要因素。(3)肝移植受者的躯体相关生存和心理相关生存质量均受性别、年龄、婚姻状况、教育程度、收入情况、宗教信仰、社会支持、医保类型、移植年限、并发症等因素影响;另外,原发病类型也是躯体相关生存质量的影响因素。(4)肝移植受者的心理弹性与生存质量成正比,患者心理弹性越高,生存质量越好。
[Abstract]:Objective: To study the effect of socio-demographic data and relevant data on the psychological elasticity and the quality of life of patients with liver transplantation. The relationship between the psychological elasticity and the quality of life of the recipient of the liver transplantation is also discussed. Methods: The cross-sectional survey was used in this study. The sampling method was used to facilitate the sampling. The patients were randomly selected from July 2015 to November 2016 in Guangzhou General Hospital of Guangzhou Military Region. The questionnaire consisted of three parts: the Chinese version of the Conor-Davidson's Psychological elasticity scale (CD-RISC), the Chinese version of the health status questionnaire (Short Form 36 Health Survey, SF-36) and the self-made general data questionnaire. the collected data results are input into an exle table to be sorted, and the sample data is statistically described by using a mean number and a standard deviation, a component ratio and the like; the psychological elasticity and the survival quality of the liver transplantation recipient are compared with the corresponding norm by using the independent sample t test; t test is adopted, The effect of variance analysis on the psychological elasticity and the quality of life of the recipients of liver transplantation was analyzed. The factors influencing the psychological elasticity of the liver transplantation recipients were analyzed by multiple stepwise regression. The psychological and survival quality factors of liver transplantation recipients were analyzed by pearson. The effect of psychoelastic high and low groups on the quality of life was tested by independent sample t. The statistical software was analyzed using SPSS 21.0. When P0.05, the difference was considered to be of statistical significance. Results: (1) The total score of the psychological elasticity and the factors of the liver transplantation recipients were lower than that of the Chinese norm (P0.05). The score of the survival quality of the liver transplantation recipients was lower than that of the Chinese norm (P0.05). (2) The results of the study of the relationship between the socio-demographic data and the clinical data and the psychological elasticity of the recipient of the liver transplantation show that the different sex, age, marital status, educational level, religious belief, monthly income, medical insurance type, the type of the original, the length of the transplant, the complication, There was a difference in the level of psychological elasticity (P0.05). (3) The social and demographic factors and the clinical-related factors that affected the psychological elasticity of the recipient of the liver transplantation were analyzed by stepwise regression. The results showed that the sex, the medical type, the complication and the income of the complication were the regression equation of the dependent variable, which together accounted for 59.3% of the whole (P0.05). There was a significant positive effect on the type of gender and medical treatment, and there was a significant negative effect on the complications. (4) The results of the study on the relationship between the quality of life and the quality of life in the body of the recipient of the liver transplantation in the study of the relationship between the quality of life and the quality of life in the body of the recipient of the liver transplantation show that the different sex, age, marital status, educational level, religious belief, monthly income, medical insurance type, and the year of transplantation, There was a difference in the level of psychological elasticity of the patients (P0.05). There was a difference in the quality of life-related life of the patients (P0.05). There was no difference in the quality of the psychological survival (P0.05). (5) The psychological elastic score of liver transplantation recipients was positively correlated with physiological function, physical function, physical pain, general health status, energy, social function, emotional function and mental health (P0.05). Conclusion: (1) The overall level of psychological elasticity of liver transplantation recipients is low, in which the performance is the worst; the quality of life in the recipients of the liver transplantation is lower. (2) The psychological elasticity of the recipient of liver transplantation is affected by the factors such as sex, age, marital status, educational level, income, religious belief, social support, type of medical insurance, type of original disease, age of transplantation, and complications. Among them, the male, the high, the married, the educational level is high, the income is good, has the religious belief, has the medical insurance, the original disease is the liver cancer, the transplant life is higher, the psychological elasticity level of the elder is higher. The factors of gender, medical type and complication are the important factors that affect the psychological elasticity of the patient. (3) The body-related survival and psychological-related quality of life in the recipient of liver transplantation are affected by the factors such as sex, age, marital status, educational level, income, religious belief, social support, type of medical insurance, age of transplantation, and complications; in addition, The original type of the disease is also the influence factor of the body-related quality of life. (4) The psychological elasticity of the recipient in the liver transplantation is directly proportional to the quality of life, and the higher the psychological elasticity of the patient, the better the quality of life.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.3
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本文编号：2444851