社会支持和应对方式对肾移植患者生存质量的影响

Influence of social support and coping style on quality of life in renal transplant patients

目的:调查社会支持和医学应对方式对肾移植患者生存质量的影响。方法:于2005-01/02选择在首都医科大学附属北京友谊医院门诊随访的成功接受肾移植手术患者60例,移植肾功能正常,均自愿参加问卷调查。应用以下3个量表:①世界卫生组织生存质量测定量表简表:包括生理领域、心理领域、社会关系领域和环境领域4个因子及自评总分,各个领域得分越高,代表该领域的生存质量越好。②领悟社会支持量表:包括家庭支持、朋友支持和其他人支持3个因子,同时以领悟社会支持总分反映个体感受的社会支持总程度,得分越高,表明个体感受到的支持程度越高。③医学应对问卷:包含面对,回避和屈服3个分量表,分量表得分越高,表明个体越倾向于采用这种应对方式。计算肾移植患者各量表得分,并与常模进行比较。分析肾移植患者领悟社会支持得分、所采用的医学应对方式得分与患者生存质量各领域得分的相关性。结果:60例患者全部进入结果分析,无脱落。①肾移植患者生存质量在生理领域、心理领域,社会关系领域及环境领域的得分均低于常模,其中在生理领域的差异有显著性意义(13.2±2.2,15.1±2.3,P<0.05)。②除生存质量的自评总分与家庭支持有关外(r=0.302,P<0.05),其余4个因子均与家庭支持无相关性(P>0.05)。生存质量各因子及自评总分均与朋友支持、其他人支持和领悟社会支持总分相关(P<0.01)。③肾移植患者回避的应对方式与生存质量中的社会关系领域呈正相关(r=0.311,P=0.016)。结论:肾移植患者生理领域的生存质量较低,生存质量受患者领悟社会支持程度及采取医学应对方式的影响。

AIM： To investigate the influences of social support and medical coping style on the quality of life （QOL） in renal transplant patients. METHODS： Sixty renal transplant out patients with normal graft function from Beijing Friendship Hospital, Capital Medical University, were enrolled into this study from January to February in 2005. All the patients were volunteered to participate in the questionnaire investigation. ①Brief Form of World Health Organization Quality of Life Questionnaire （WHOQOL-BREF） coveres four domains of physical capacity, psychological state, social functioning, environment, additionally the self-rating total scores by patients. A higher score indicates a better QOL. ②Perceived Social Support Scale includes three dimensions of family support, friend support, and other support. The total scores reflect the level of social support perceived by the individual patient. A higher score indicates a higher perceived social support. ③Medical Coping Modes Questionnaire is classified into three coping style subscales of confrontation, avoidance, and acceptance-resignation. A higher score indicates a better coping tendency adopted by patients. Renal transplant patients were scored by each scale, and were compared with the norms. Pearson＇s correlation analysis was used to explore the influence of social support and medical coping style on the QOL in renal transplant patients. RESULTS： Sixty renal transplant patients were all involved in the result analysis.①The mean scores of physical capacity, psychological state, social functioning, and environment in QOL were lower than that of the norms, only the score of physical capacity was statistically significant between the renal transplant patients and the norms （13.2＋2.2, 15.1 ＋2.3, P 〈 0.05）. ②Four factors of WHOQOL-BREF were not correlated with family support （P 〉 0.05）, except the self-rating total score （r =0.302, P 〈 0.05）. Each factor of WHOQOL-BREF and the self-rating total scores were correlated with the scores of perceived social support, friend support and other support （P 〈 0.01 ）.③Avoidance coping style was positively correlated with the social relationship domain of WHOQOL-BREF （r =0.311, P =0.016）. CONCLUSION： The physical capacity domain of QOL in renal transplant patients is lower. The QOL of renal transplant patients is influenced by the perceived social support and medical coping style.