肺移植患者术后生命质量及其影响因素研究

Research in quality of life in patients after lung transplantation and its related factors

目的 了解肺移植患者术后的生命质量及其影响因素.方法 应用方便抽样,采用36条目简明健康调查量表（SF-36）、呼吸道疾病问卷（AQ20-R）、焦虑自评量表（SAS）、抑郁自评量表（SDS）和医学应对问卷（MCMQ）对30例肺移植术后患者进行调查.采用SPSS 20.0软件进行统计学分析,用Pearson线性相关进行关联性分析,多重线性回归进行多因素分析.结果 肺移植患者术后SF-36各维度得分为（34.48±16.73）^（71.63±22.83）分,除精神健康外得分均小于常模（Z=-9.684^-2.817,P〈0.01）,其中躯体疼痛得分最高为（71.63±22.83）分,生理功能得分最低为（34.48±16.73）分;AQ20-R总分的均分为（7.93±5.21）分,影响肺移植患者术后生命质量的前2个呼吸相关问题分别是＂因为暴露于强烈的气味、烟雾或香水味而感到肺部不适＂＂在感冒后因肺部疾病感到精疲力竭＂;SAS及SDS得分分别为（44.33±9.33）、（48.05±9.80）分,高于常模的（33.80±5.90）、（41.88±10.57）分,差异有统计学意义（t=6.1833、3.4458,P〈0.01）;MCMQ的面对、回避、屈服各维度得分分别为（8.93±2.08）、（16.10±2.28）、（3.63±1.33）分,与常模的得分（19.48±3.81）、（14.44±2.97）、（8.81±3.17）分比较,差异有统计学意义（t=-27.7281、3.9885、-21.3878,P〈0.01）.焦虑、抑郁、医学应对方式采用屈服应对是影响肺移植患者术后生命质量的主要因素.结论 肺移植患者术后生命质量最差的方面是生理职能,最好的方面是躯体疼痛;肺移植患者术后生命质量基本比一般人群差.肺移植患者术后生命质量可能的影响因素有焦虑、抑郁、屈服应对.

 Objective To acknowledge the quality of life （QOL） in patients after lung transplantation and to explore related factors. Methods A cross- sectional study design and a convenience sampling were performed in this research. Totally 30 patients after lung transplantation were investigated. The questionnaires which used to explore the quality of life were Short Form 36 Health Survey Questionnaires （SF-36） and Revised Airways Questionnaires 20 （AQ20-R）. Related state were surveyed by questionnaires consisted of demographic questionnaires, Self-rating Anxiety Scale （SAS）, Self-rating Depression Scale （SDS） and Medical Coping Mode Questionnaires （MCMQ）. Statistical analysis was performed by SPSS 20.0 software. Correlation analysis and multivariate analysis were performed using Pearson linear correlation analysis and multi-linear regression. Results The scores among the 8 dimensions of SF-36 were（34.48±16.73）-（ 71.63±22.83）, lower than those of norms（Z=-9.684--2.817, P〈0.05 or 0.01）. Somatic pain scored the highest （71.63±22.83）, while physiological function scored the lowest （34.48±16.73）. The mean score of AQ20-R was 7.93±5.21. The major two problems that manifested QOL were： ＂uncomfortable feeling of lung caused by strong scent, smog or perfume＂, ＂exhausted feeling after having a cold＂. The mean scores of SAS and SDS were 44.33±9.33,48.05±9.80, higher than those of norms, which were 33.80 ± 5.90, 41.88 ± 10.57 （t=6.1833, 3.4458, P 〈 0.01）. The scores among the 3 dimensions of MCMQ were 8.93 ± 2.08, 16.10 ± 2.28, 3.63 ± 1.33 and the differences were significant in 3 dimensions compared with those norms, which were 19.48±3.81, 14.44±2.97, 8.81±3.17（t=-27.7281, 3.9885,-21.3878, P〈0.01）. Conclusions In SF-36, role-physical of patients after lung transplantation was the worst dimension, while bodily pain was the best dimension of QOL. The QOL of patients after lung transplantation were almost worse than normal people. The related factors of QOL in patients after lung transplantation maybe：anxiety, depression and medical coping style.