肝移植术后患者疲劳状况与依从性和生命质量的相关性研究

The relationship between status of fatigue and compliance,quality of life in patients after liver transplantation

目的 研究肝移植术后患者疲劳状况与依从性和生命质量的关系,为提高肝移植术后患者依从性,改善其生命质量提供理论依据.方法 采用疲劳评定量表（FAI）、依从性量表和健康状况调查问卷（SF-36）对2012年6月至2015年6月在西京医院器官移植中心进行随访的104例肝移植术后患者进行调查分析.采用Spearman相关分析对肝移植术后患者疲劳状况与服药依从性和生命质量的关系进行分析.结果 肝移植术后患者的疲劳程度显著高于一般人群和冠心病患者.除疲劳因子4以外,肝移植术后12个月时患者疲劳因子1、因子2和因子3得分分别为（5.73±0.75）、（5.39±0.72）、（5.42±0.70）分,均低于术后1个月的（6.27±0.76）、（6.05±0.74）、（6.10±0.72）分,差异有统计学意义（t=2.98、3.85、4.25,P〈0.05）,低于6个月的（6.12±0.83）、（5.89±0.74）、（5.94±0.57）分,差异有统计学意义（t=2.76、3.37、3.14,P〈0.05）,肝移植术后1个月和6个月患者各疲劳因子得分比较则差异无统计学意义（P〉0.05）.根据FAI因子1得分对患者进行分级,其中中度疲劳63例,重度疲劳41例.中度疲劳患者依从性总分、SF-36生理健康总分和SF-36心理健康总分分别为（70.33±7.82）、（268.37±46.22）、（277.60±47.75）分,均高于重度疲劳患者的（61.47±8.05）、（220.71±45.93）、（228.26±47.09）分,差异有统计学意义（t=2.94、3.13、3.58,P〈0.05）.Spearman相关分析结果显示,肝移植术后患者4个疲劳因子同依从性总分（r=-0.482、-0.394、-0.454、-0.420）、SF-36生理健康总分（r=-0.491、-0.416、-0.447、-0.435）和SF-36心理健康总分（r=-0.627、-0.466、-0.570、-0.542）呈显著负相关（P〈0.05）.结论 肝移植术后患者疲劳程度较高,且与患者生命质量和依从性存在负相关.护理人员应了解肝移植术后患者疲劳状况并及时缓解,可以有效改善肝移植术后患者的生命质量.

Objective To investigate the relationship between status of fatigue and compliance, quality of life in patients after liver transplantation, which in order to provide a scientific basis for improving compliance and quality of life of them. Methods One hundred and four liver transplant recipients who received liver transplantation from Jun 2012 to Jun 2015 were recruited in this study.The status of fatigue, compliance and quality of life of these patients were assessed by Fatigue Assessment Instrument（FAI）,compliance scale and the MOS 36-item short-form health survey（SF-36）respectively. Spearman correlation coefficients were used to analyze the relationship between status of fatigue and compliance, quality of life. Results The degree of fatigue in patients after liver transplantation was significantly higher than that in the general population and patients with coronary heart disease. Except the fatigue factor 4, the fatigue factor 1, factor 2 and factor 3 scores of the patients at the end of the 12 month after liver transplantation were lower than those at the end of the 1 month and 6 months after liver transplantation（P〈0.05）.There was no significant difference in the scores of fatigue factors between 1 and 6 months after liver transplantation（P〉0.05）.The patients were graded according to the FAI fatigue rating scale factor 1 score,of which 63 cases were moderate fatigue,and the other was severe fatigue（n=41）.The Results showed that the total score of compliance, the total score of SF-36 physical health and the total score of SF-36 mental health of the moderate fatigue group were higher than that of the severe fatigue group （P〈0.05）.Spearman correlation coefficients showed that all fatigue factors of patients post-transplantation was negatively correlated with quality of life and compliance（P〈0.05）. Conclusions There is high level of fatigue in patients after liver transplantation, and which negatively correlated with quality of life and compliance.Nursing staff should comprehend the fatigue status of patients after liver transplantation and relieve timely.Which could improve the quality of life of patients post-transplantation.