肾移植受者生活质量与乐观和心理一致感的相关性
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摘要
目的了解肾移植受者生活质量与乐观和心理一致感现状,并分析三者的路径关系。方法采用便利抽样方法,选取在天津市某三甲医院就诊的295例肾移植受者,采用一般情况调查表、简明健康状况调查问卷(the MOS 36-item short form health survey, MOS SF-36)、心理一致感量表(sense of coherence-13, SOC-13)和生活取向测验量表(revised life orientation test, LOT-R)进行调查。结果肾移植受者生理健康总分为(47.02±7.30)分,不同年龄、就业状况和移植术后时间的肾移植受者评分比较,差异有统计学意义(P<0.01);心理健康总分为(46.87±11.14)分,不同文化程度、经济负担和移植术后时间的肾移植受者评分比较,差异有统计学意义(P<0.05)。肾移植受者LOT-R总分为(22.07±3.08)分和SOC-13总分(46.87±11.14)分,两者分别与生理健康、心理健康总分呈正相关(P<0.001),乐观的中介效应对生理健康和心理健康总效应的贡献率分别为52.05%和23.45%。结论肾移植受者生活质量水平处于较低水平;心理一致感处于中等偏低水平;乐观处于中等偏上水平,乐观在心理一致感对生活质量的影响中起部分中介作用。加强肾移植受者心理状态的评估,同时密切关注受者情感变化,给予情感和精神上的支持,以提高肾移植受者乐观和心理一致感水平,从而改善受者心理水平及生活质量。
Objective To explore the relationship of quality of life with optimisms and sense of coherence in adult kidney transplant recipients. Method A total of 295 kidney transplant recipients participated in the study by a self-designed general questionnaire, revised life orientation test(LOT-R), sense of coherence(SOC-13) and the MOS 36-item short form health survey(MOS SF-36). Results The mean score of mental health scale(PCS) was 47.02±7.30, which differed with different age, employment status and transplant vintage(P <0.01). The mean score of phyical health scale(MCS) was 46.87 ±11.14, which differed with education,economic burden and transplant vintage(P <0.05). PCS and MCS were positively correlated with the total score of sense of coherence(52.05%) and optimism(23.45%)(P<0.001). Optimism played a partially mediating role in the relationship between sense of coherence and quality of life. Conclusions The quality of life of kidney transplant recipients needs to be improved, which was at a low level.Optimism(medium to high level)and sense of coherence(medium to low level) are influencing factors of the quality of life. Improving accessment of mental state of patients with kidney transplant receients, paying more atentent and support to their mental change can improve their optimism and sense of coheherce and then life quiality.
Objective To explore the relationship of quality of life with optimisms and sense of coherence in adult kidney transplant recipients. Method A total of 295 kidney transplant recipients participated in the study by a self-designed general questionnaire, revised life orientation test(LOT-R), sense of coherence(SOC-13) and the MOS 36-item short form health survey(MOS SF-36). Results The mean score of mental health scale(PCS) was 47.02±7.30, which differed with different age, employment status and transplant vintage(P <0.01). The mean score of phyical health scale(MCS) was 46.87 ±11.14, which differed with education,economic burden and transplant vintage(P <0.05). PCS and MCS were positively correlated with the total score of sense of coherence(52.05%) and optimism(23.45%)(P<0.001). Optimism played a partially mediating role in the relationship between sense of coherence and quality of life. Conclusions The quality of life of kidney transplant recipients needs to be improved, which was at a low level.Optimism(medium to high level)and sense of coherence(medium to low level) are influencing factors of the quality of life. Improving accessment of mental state of patients with kidney transplant receients, paying more atentent and support to their mental change can improve their optimism and sense of coheherce and then life quiality.
引文
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[5]ANNALISA G.Effects of dispositional optimism on quality of life,emotional distress and disability in Parkinson’s disease outpatients under rehabilitation[J].Functional Neurology,2015,30(1):53-57.
[6]GUSTAVSSON-LILIUS M,JULKUNEN J,KESKI-VAARA P,et al.Predictors of distress in cancer patients and their partners:the role of optimism in the sense of coherence construct[J].Psychology&Health,2012,27(2):178-195.
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[10]LAI C L,CHEUNG H,LEE W M,et al.The utility of the revised life orientation test to measure optimism among Hong Kong Chinese[J].International Journal of Psychology,1998,33(1):45-56.
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[12]ERIKSSON M,LINDSTR魻M B,LILJA J.A sense of coherence and health.Salutogenesis in a societal context:Aland,a special case?[J].Journal of Epidemiology&Community Health,2007,61(8):684-8.
[13]JR W J,GANDEK B.Overview of the SF-36 health survey and the international quality of life assessment(IQO-LA)project[J].Journal of Clinical Epidemiology,1998,51(11):903-912.
[14]MOUELHI Y,JOUVE E,ALESSANDRINI M,et al.Factors associated with health-related quality of life in kidney transplant recipients in France[J].Bmc Nephrology,2018,19(1):99.
[15]GRIVA K,DAVENPORT A,HARRISON M,et al.Non-adherence to immunosuppressive medications in kidney transplantation:intent vs.forgetfulness and clinical markers of medication intake[J].Annals of Behavioral Medicine,2012,44(1):85-93.
[16]武海环.肾移植患者社会支持、家庭功能、心理一致感与生活质量的相关性研究[D].山东:山东大学,2018.
[17]COSTA-REQUENA G,CANTARELLAIXENDRI M C,PARRAMONPUIG G,et al.Dispositional optimism and coping strategies in patients with a kidney transplant[J].Nefrologia,2014,34(5):605-610.
[18]CELANO C M,GOMEZ-BERNAL F,MASTROMAUROC A,et al.A positive psychology intervention for patients with bipolar depression:a randomized pilot trial[J].Journal of Mental Health,2018,26:1-9.
[19]朱美侠,蔡丹,武云露,等.大学生社会支持对乐观倾向的影响:心理弹性与心理一致感的中介作用[J].心理科学,2016,39(02):371-376.
[20]DAVID D,SZENTAGOTAI A,LUPU V,et al.Rational emotive behavior therapy,cognitive therapy,and medication in the treatment of major depressive disorder:a randomized clinical trial,posttreatment outcomes,and sixmonth follow-up[J].Journal of Clinical Psychology,2010,64(6):728-746.
[21]MOGHADDAM F T,ALIZADEH S.Family intervention based on the FOCUS program effects on cancer coping in Iranian breast cancer patients:arandomizedcontrol trial[J].Asian Pacific Journal of Cancer Prevention Apjcp,2018,19(6):1523-1528.
[22]杨士来,王晓霞,彭山玲,等.认知行为疗法对肾移植受者术后负性情绪和睡眠质量的效果研究[J].解放军护理杂志,2017,34(13):6-10.
[2]ROZANSKI A.Optimism and other sources of psychological well-being:a new target for cardiac disease prevention[J].Circulation Heart Failure,2014,7(3):385-387.
[3]L魧NSIMIES H,PIETIL魧M,HIETASOLA-HUSU S,et al.A systematic review of adolescents’sense of coherence and health[J].Scandinavian Journal of Caring Sciences,2017,31(4):651-661.
[4]杜春燕.基于症状经历模型对肾移植受者症状经历的研究[D].北京:北京中医药大学,2018.
[5]ANNALISA G.Effects of dispositional optimism on quality of life,emotional distress and disability in Parkinson’s disease outpatients under rehabilitation[J].Functional Neurology,2015,30(1):53-57.
[6]GUSTAVSSON-LILIUS M,JULKUNEN J,KESKI-VAARA P,et al.Predictors of distress in cancer patients and their partners:the role of optimism in the sense of coherence construct[J].Psychology&Health,2012,27(2):178-195.
[7]孙振球,徐勇勇.医学统计学[M].4版.北京:人民卫生出版社,2014:9.
[8]王济川,王小倩.结构方程模型:Mplus与应用[M].北京:高等教育出版社,2012:78-85.
[9]SCHEIER M F,CARVER C S,BRIDGES M W.Distinguishing optimism from neuroticism(and trait anxiety,self-mastery,and self-esteem):a reevaluation of the Life Orientation Test[J].J Pers Soc Psychol,1994,67(6):1063-1078.
[10]LAI C L,CHEUNG H,LEE W M,et al.The utility of the revised life orientation test to measure optimism among Hong Kong Chinese[J].International Journal of Psychology,1998,33(1):45-56.
[11]包蕾萍,刘俊升,周颖,等.心理一致感量表(SOC-13)的信、效度初步研究[J].中国心理卫生杂志,2006,20(5):299-301.
[12]ERIKSSON M,LINDSTR魻M B,LILJA J.A sense of coherence and health.Salutogenesis in a societal context:Aland,a special case?[J].Journal of Epidemiology&Community Health,2007,61(8):684-8.
[13]JR W J,GANDEK B.Overview of the SF-36 health survey and the international quality of life assessment(IQO-LA)project[J].Journal of Clinical Epidemiology,1998,51(11):903-912.
[14]MOUELHI Y,JOUVE E,ALESSANDRINI M,et al.Factors associated with health-related quality of life in kidney transplant recipients in France[J].Bmc Nephrology,2018,19(1):99.
[15]GRIVA K,DAVENPORT A,HARRISON M,et al.Non-adherence to immunosuppressive medications in kidney transplantation:intent vs.forgetfulness and clinical markers of medication intake[J].Annals of Behavioral Medicine,2012,44(1):85-93.
[16]武海环.肾移植患者社会支持、家庭功能、心理一致感与生活质量的相关性研究[D].山东:山东大学,2018.
[17]COSTA-REQUENA G,CANTARELLAIXENDRI M C,PARRAMONPUIG G,et al.Dispositional optimism and coping strategies in patients with a kidney transplant[J].Nefrologia,2014,34(5):605-610.
[18]CELANO C M,GOMEZ-BERNAL F,MASTROMAUROC A,et al.A positive psychology intervention for patients with bipolar depression:a randomized pilot trial[J].Journal of Mental Health,2018,26:1-9.
[19]朱美侠,蔡丹,武云露,等.大学生社会支持对乐观倾向的影响:心理弹性与心理一致感的中介作用[J].心理科学,2016,39(02):371-376.
[20]DAVID D,SZENTAGOTAI A,LUPU V,et al.Rational emotive behavior therapy,cognitive therapy,and medication in the treatment of major depressive disorder:a randomized clinical trial,posttreatment outcomes,and sixmonth follow-up[J].Journal of Clinical Psychology,2010,64(6):728-746.
[21]MOGHADDAM F T,ALIZADEH S.Family intervention based on the FOCUS program effects on cancer coping in Iranian breast cancer patients:arandomizedcontrol trial[J].Asian Pacific Journal of Cancer Prevention Apjcp,2018,19(6):1523-1528.
[22]杨士来,王晓霞,彭山玲,等.认知行为疗法对肾移植受者术后负性情绪和睡眠质量的效果研究[J].解放军护理杂志,2017,34(13):6-10.