肺移植受者术后抑郁调查及影响因素分析

Postoperative depression and its influencing factors among lung transplant recipients

目的纵向追踪肺移植受者术后抑郁情绪水平的动态变化并分析其影响因素,为临床开展精准心理护理提供参考。方法于2022年10月—2023年12月,便利抽取广州市某三级甲等医院肺移植受者,采用自编一般资料问卷、患者健康问卷、移植症状发生和症状困扰量表,于术后出院前1 d(T0)、术后3个月(T1)、术后6个月(T2)3个时间点开展调查。结果共62例肺移植受者完成3个时间点调查,其抑郁情绪得分在T0、T1、T2时点的中位数分别为9.00(4.00,14.00)、5.00(1.75,10.00)和3.00(0.00,9.00),呈下降趋势(Z=38.174,P<0.001)。线性混合模型分析结果显示,肺移植受者年龄增长(β=0.012,P=0.043)、术后住院时间延长(β=0.006,P=0.025)、症状发生频率及严重程度越高(β=0.038,P<0.001)是其抑郁情绪的危险因素,轻度经济负担(β=-0.469,P=0.005)是其抑郁情绪的保护因素。结论肺移植受者抑郁情绪术后随时间推移呈逐渐降低趋势。医护人员应重点关注高龄、经济条件差、伴随多种症状的肺移植受者,及时提供个性化精准心理护理,促进其身心全面康复。

Objective To conduct a longitudinal study on dynamic change of postoperative depression of lung transplant recipients and analyze its influencing factors,and to provide reference for clinical precision psychological nursing.Methods Using convenience sampling,lung transplant recipients admitted to a tertiary grade-A hospital in Guangzhou from October 2022 to December 2023 were selected as research subjects.Longitudinal surveys were conducted using a Self-designed General Information Questionnaire,Patient Health Questionnaire-9(PHQ-9),and Modified Transplant Symptom Occurrence and Symptom Distress Scale(MTSOSD)on the day before discharge(T0),3 months after operation(T1)and 6 months after operation(T2).Results A total of 62 patients completed all surveys at the three time points.The median score of depression at T0,T1 and T2 was 9.00(4.00,14.00),5.00(1.75,10.00)and 3.00(0.00,9.00),respectively,showing a decreasing trend(Z=38.174,P<0.001).Linear mixed model analysis showed that increased age(β=0.012,P=0.043),prolonged postoperative hospital stay(β=0.006,P=0.025),and higher frequency and severity of symptoms(β=0.038,P<0.001)were risk factors for depression,and mild economic burden(β=-0.469,P=0.005)was a protective factor for depression.Conclusion Postoperative depression of lung transplant recipients shows a gradual decrease over time.Medical staff should focus on elderly recipients,recipients with low family income,and those accompanied by multiple symptoms.Timely personalized and precise psychological care are conducive to promoting their physical and mental rehabilitation.