| 郭韵,周立娜,张峰,陈玉梅,卜宗慧,万文锦.肝移植受者自我感受负担与生活质量的关系：焦虑抑郁的作用路径[J].四川精神卫生杂志,2024,37(5):444-450.,Relation between self-perceived burden and quality of life in liver transplant recipients： the effecting path of anxiety and depression[J].SICHUAN MENTAL HEALTH,2024,37(5):444-450 |
| 肝移植受者自我感受负担与生活质量的关系：焦虑抑郁的作用路径 |
| Relation between self-perceived burden and quality of life in liver transplant recipients： the effecting path of anxiety and depression |
| 投稿时间：2023-11-01 |
| DOI：10.11886/scjsws20231101003 |
| 中文关键词: 肝移植 自我感受负担 焦虑 抑郁 生活质量 |
| 英文关键词:Liver transplantation Self-perceived burden Anxiety Depression Quality of life |
| 基金项目:江苏省人民医院2021年度“临床能力提升工程”护理项目（项目名称：肝移植受者自我感受负担、焦虑抑郁及生活质量的相关性研究，项目编号：JSPH-NC-2021-18） |
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| 中文摘要: |
| 背景 自我感受负担和焦虑抑郁是生活质量的重要影响因素。目前关于肝移植受者自我感受负担的研究现状及影响因素尚缺乏了解。既往研究显示，自我感受负担、焦虑抑郁与生活质量两两相关，但三者之间的作用路径尚不明确。目的 探讨肝移植受者自我感受负担、焦虑抑郁与生活质量三者之间的关系，为其心理护理提供参考。方法 选取2022年3月—2023年2月江苏省人民医院和中国人民解放军东部战区总医院秦淮医疗区肝移植中心住院和门诊随访的200例肝移植受者为研究对象。采用自我感受负担量表（SPBS）、医院焦虑抑郁量表（HADS）、中文版肝移植后生活质量调查问卷（pLTQ）进行评定。采用Spearman相关分析考查各量表评分的相关性。应用Mplus 8.3构建结构方程模型，探究肝移植受者自我感受负担、焦虑抑郁和生活质量三者之间的关系，使用Bootstrap法检验作用路径。结果 不同受教育程度和家庭年收入的肝移植受者SPBS总评分比较，差异均有统计学意义（H=9.656、18.796，P均<0.05）。不同躯体症状数量的肝移植受者HADS总评分比较，差异有统计学意义（H=9.859，P<0.05）。不同受教育程度、术后存活时间和躯体症状数量的肝移植受者中文版pLTQ总评分比较，差异均有统计学意义（H=6.892、8.023、16.099，P均<0.05）。肝移植受者SPBS总评分及各维度评分与HADS总评分及焦虑、抑郁维度评分均呈正相关（r=0.464~0.586、0.460~0.593、0.286~0.408、0.464~0.583，P均<0.01），与中文版pLTQ总评分及各维度评分均呈负相关（r=-0.572~-0.416、-0.599~-0.441、-0.365~-0.213、-0.559~-0.428，P均<0.01）。结构方程模型结果显示，自我感受负担可负向影响生活质量（β=-0.186，P<0.01），焦虑抑郁可负向影响生活质量（β=-0.679，P<0.01）。自我感受负担通过焦虑抑郁影响肝移植受者的生活质量，间接效应值为-0.429，占总效应的69.76%。结论 肝移植受者生活质量可能与自我感受负担和焦虑抑郁相关，自我感受负担可能通过焦虑抑郁影响其生活质量。 |
| 英文摘要: |
| Background Self-perceived burden， anxiety and depression are among the most important factors affecting quality of life. At present， there is a lack of understanding on the research status and influencing factors of self-perceived burden in liver transplant recipients. Previous studies have shown that self-perceived burden， anxiety， depression and quality of life are correlated in pairs， but the effecting path among the three are not yet clear.Objective To explore the correlation of self-perceived burden and anxiety/depression with quality of life in liver transplant recipients， so as to provide guidance for psychological nursing intervention in clinical patients.Methods A total of 200 patients liver transplant recipients were enrolled from the liver transplantation inpatient and outpatient clinics of Jiangsu Province Hospital and Qinhuai Medical Area， General Hosptial of Eastern Theater Command of People's Liberation Army of China from March 2022 to February 2023. Patients were evaluated using Self-perceived Burden Scale （SPBS）， Hospital Anxiety and Depression Scale （HADS） and the Chinese version of Post Liver Transplant Quality of Life Questionnaire （pLTQ）. Spearman correlation analysis was used to examine the correlation among the scales. A structural equation model using Mplus 8.3 was utilized to testify the relationship among self-perceived burden， anxiety/depression and quality of life in liver transplant recipients. Bootstrap method was used to test the effecting pathway.Results There were statistically significant differences in SPBS scores of liver transplant recipients with different levels of education and fannual family income （H=9.656， 18.796， P<0.05）. There were statistically significant differences in HADS scores of liver transplant recipients with different numbers of somatic symptoms （H=9.859， P<0.05）. There were statistically significant differences in the Chinese version of pLTQ scores of liver transplant recipients with different levels of education， postoperative survival time and numbers of somatic symptoms （H= 6.892， 8.023， 16.099， P<0.05）. The total and each dimension scores in SPBS of liver transplant recipients were positively correlated with the total score and anxiety/depression dimension scores in HADS （r=0.464~0.586， 0.460~0.593， 0.286~0.408， 0.464~0.583， P<0.01） and negatively correlated with the total score and each dimension scores in the Chinese version of pLTQ （r=-0.572~-0.416， -0.599~-0.441， -0.365~-0.213， -0.559~-0.428， P<0.01）. Structural equation model denoted that self-perceived burden negatively affected quality of life （β=-0.186， P<0.01）. Anxiety/depression also negatively affected quality of life （β=-0.679， P<0.01）. The self-perceived burden indirectly affected the quality of life of liver transplant recipients through anxiety and depression， with an effect value of -0.429， accounting for 69.76% of the total effect.Conclusion The quality of life in liver transplant recipients may be related to their self-perceived burden and anxiety/depression. Self-perceived burden may affect the quality of life of liver transplant patients through anxiety and depression.［Funded by Jiangsu Province Hospital "Clinical Ability Enhancement" Nursing Project in 2021 （number， JSPH-NC-2021-18）］ |
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