新型冠状病毒肺炎暴发期间肝移植受者服药依从性与生命质量调查研究

Investigation on medication adherence and quality of life of liver transplant recipients in a hospital in Shanghai during the outbreak of novel coronavirus pneumonia

目的调查新型冠状病毒肺炎(COVID-19)暴发期间肝移植受者服药依从性及生命质量,为今后突发公共卫生事件发生时对肝移植受者的健康管理提供依据。方法2020年2月17日至2月21日对长期随诊于上海交通大学医学院附属仁济医院的183例成人肝移植受者进行问卷调查。问卷由一般资料、免疫抑制剂治疗依从性Basel评估量表(BAASIS)及肝移植后生活质量调查问卷(pLTQ)组成。经数据分析获得疫情期间肝移植受者服药依从性及生命质量情况,并通过多元线性回归分析探讨二者的影响因素。结果180例样本纳入分析。肝移植受者服药依从性得分为(5.25±2.26)分,57.22%(103/180)受者依从性好;生命质量得分为(146.51±29.73)分。患者服药依从性的影响因素为术后未能正常工作(b’=-0.192,P=0.008)、术后时间长(b’=0.188,P=0.009)、少数民族(b’=0.186,P=0.010)。患者生命质量的影响因素为睡眠质量差(b’=-0.252,P<0.01)、家庭人均月收入高(b’=0.212,P=0.003)、术后时间长(b’=0.177,P=0.009)、术后未能正常工作(b’=-0.150,P=0.036)。结论疫情期间肝移植受者的服药依从性较好、生命质量未受到明显影响。但术后正常工作、术后时间长和少数民族对服药依从性的负向影响,睡眠质量差、收入低、术后时间短、术后未能正常工作对生命质量的负向影响,临床中应引起充分重视。

Objective To investigate the medication adherence and quality of life in adult liver transplant(LT)recipients during the epidemic of 2019 novel coronavirus pneumonia(COVID-19)in China and to provide guidance for health management of LT recipients in the face of public health emergencies.Methods A cross-sectional survey was conducted among 183 cases of adult LT recipients followed up in our hospital from 17th to 21st February 2020.The questionnaire consisted of self-designed general data questionnaire,the Basel Assessment of Adherence Immunosuppressive Medications Scale(BAASIS)and post-liver transplant quality of life(pLTQ).The data was analyzed to investigate the medication adherence and quality of life of LT recipients during the COVID-19 pandemic,and the influencing factors were analyzed by multiple linear regression analysis.Results One hundred and eighty samples were included in the analysis.①The BAASIS score of medication adherence was(5.25±2.26)points,and the pLTQ score of quality of life was(146.51±29.73)point.Among all the recipients,57.22%were with good medication adherence.②The independent influencing factors of the medication adherence in LT recipients included“unemployment after surgery”(b'=-0.192,P=0.008),“long survival time”(b'=0.188,P=0.009),and“minority nationality”(b'=0.186,P=0.010).③The independent influencing factors of life quality in LT recipients included“poor sleep quality”(b'=-0.252,P=0.000),“high monthly per capita income”(b'=0.212,P=0.003),“long survival time”(b'=0.177,P=0.009),and“unemployment after the surgery”(b'=-0.150,P=0.036).Conclusion The medication adherence of LT recipients was better during the COVID-19 pandemic than normal period,and the quality of life was not significantly affected.However,employment after operation,long survival time and minority nationality played negative effects on patients’medication adherence.And poor sleep quality,low income,short survival time,and unemployment after operation played negative effects on patients’quality of life.Patients with these features need more attention,targeted guidance and nursing intervention.