本文選題：活體腎移植 + 生活質(zhì)量��； 參考：《中南大學(xué)》2010年碩士論文

【摘要】： 目的：1.描述腎移植供者術(shù)后生活質(zhì)量和心理健康現(xiàn)狀；2.分析影響供者術(shù)后生活質(zhì)量和心理健康的相關(guān)因素。為進(jìn)一步預(yù)測(cè)腎移植供者術(shù)后生活質(zhì)量、心理健康、實(shí)施干預(yù)措施提供依據(jù)和參考。 方法：采用SF-36簡(jiǎn)明健康量表、抑郁自評(píng)量表(SDS)、焦慮自評(píng)量表(SAS)和社會(huì)支持評(píng)定量表(SSRS),對(duì)103例腎移植供者進(jìn)行問(wèn)卷調(diào)查。將腎移植供腎者SF-36簡(jiǎn)明健康量表得分、SDS得分、SAS得分與正常參照人群的參考值進(jìn)行比較,以了解腎移植供者生活質(zhì)量和心理健康現(xiàn)狀。然后采用Pearson和Spearman相關(guān)分析、多元回歸分析及病例對(duì)照研究的方法分析影響腎移植供者生活質(zhì)量和心理健康的因素。 結(jié)果：1.與正常人群相比腎移植供者術(shù)后生活質(zhì)量8個(gè)維度中情感職能、精神狀態(tài)、活力和健康總評(píng)價(jià)分值均高于常模(P0.05)；心理健康狀況和社會(huì)支持明顯好于正常人群(P0.05)。 2.相關(guān)分析顯示：年齡與生活質(zhì)量8個(gè)維度中的生理功能、生理職能、情感職能、社會(huì)功能、疼痛、活力、精神狀態(tài)均呈負(fù)相關(guān)(P0.05),提示老齡供者生活質(zhì)量較差；性別與生理功能、情感職能、活力和健康總評(píng)價(jià)呈負(fù)相關(guān)(P0.05),提示男性供者生理狀況、心理健康較好；供受者關(guān)系與生活質(zhì)量的8個(gè)維度均呈負(fù)相關(guān)(P0.05),提示關(guān)系越密切生活質(zhì)量越差；文化水平與生理功能、生理職能、社會(huì)功能、疼痛、活力、精神狀態(tài)及健康總評(píng)價(jià)均呈正相關(guān)(P0.05),提示文化程度較高的供者身心狀況較好；婚姻與健康總評(píng)價(jià)、生理職能、活力呈負(fù)相關(guān)(P0.05),提示未婚供者總體健康較好；術(shù)后時(shí)間與健康總評(píng)價(jià)和生理職能呈正相關(guān)(P0.05),提示術(shù)后時(shí)間越久健康狀況越好；經(jīng)濟(jì)狀況與生理功能、生理職能、疼痛呈正相關(guān)(P0.05),提示經(jīng)濟(jì)狀況較好的供者機(jī)體功能和職能恢復(fù)較好；抑郁自評(píng)得分(SDS)和焦慮自評(píng)得分(SAS)與生活質(zhì)量8個(gè)維度均呈負(fù)性相關(guān)(P0.05),提示有焦慮和抑郁情緒的供者生活質(zhì)量較差；社會(huì)支持度、主觀支持得分、社會(huì)支持利用度與供者術(shù)后生活質(zhì)量的8個(gè)維度均呈正相關(guān)(P0.05),提示社會(huì)支持越高的供者生活質(zhì)量越好。 年齡、供受者關(guān)系與抑郁、焦慮得分呈正相關(guān)(P0.05),提示老齡、關(guān)系密切的供者心理健康較差；婚姻、性別與焦慮得分呈正相關(guān)(P0.05),提示已婚、女性供者易焦慮；經(jīng)濟(jì)狀況、文化程度、社會(huì)支持與抑郁、焦慮得分呈負(fù)相關(guān)(P0.05),提示社會(huì)經(jīng)濟(jì)狀況較好、社會(huì)支持較高的供者心理健康狀況較好。 性別與社會(huì)支持客觀得分呈負(fù)相關(guān)(P0.05),提示男性的社會(huì)支持客觀得分較高；供受者關(guān)系與社會(huì)支持度、社會(huì)支持客觀得分、社會(huì)支持主觀得分、社會(huì)支持利用度均呈負(fù)性相關(guān)(P0.05),提示關(guān)系越密切社會(huì)支持越差；文化水平與社會(huì)支持利用度呈正相關(guān)(P0.05),文化程度越高的供者社會(huì)支持利用度越高。 3.多元回歸顯示：供者術(shù)后心理健康狀況(尤其是焦慮情緒),以及社會(huì)支持(尤其是主觀得分和利用度)是生活質(zhì)量及心理健康各個(gè)方面最重要的影響因素；供者術(shù)后抑郁、焦慮得分主要受社會(huì)支持和供受關(guān)系的影響；供受者關(guān)系是影響供者術(shù)后社會(huì)支持的最大因素。 結(jié)論：1.在我國(guó),腎移植供者主要來(lái)源于農(nóng)村、老齡、女性、低文化水平、低經(jīng)濟(jì)水平、供受關(guān)系密切的親屬；且這部分供者生活質(zhì)量和心理健康狀況相對(duì)較差。 2.可能影響供者心理健康狀況的社會(huì)生活事件強(qiáng)弱依次是：受者的身體健康狀況、受者的家庭經(jīng)濟(jì)問(wèn)題、腎移植術(shù)后移植腎功能情況、供者自身家庭經(jīng)濟(jì)狀況、供者自身身體健康狀況和供腎摘取術(shù)后孤立腎對(duì)于未來(lái)生活和工作的影響。 3.腎移植供者術(shù)后生活質(zhì)量、心理健康、社會(huì)支持均好于普通人群。 4.影響供者術(shù)后生活質(zhì)量的因素很多,主要受心理健康狀況(尤其是焦慮情緒),以及社會(huì)支持(尤其是主觀得分和利用度)的影響。 5.供者術(shù)后心理健康主要受社會(huì)支持和供受關(guān)系的影響。
[Abstract]:Objective: 1. to describe the quality of life and mental health of donors after renal transplantation; 2. to analyze the related factors affecting the quality of life and mental health of the donors after operation, and to provide the basis and reference for further prediction of the quality of life, mental health and intervention measures for the recipients of renal transplantation.
Methods: the SF-36 simple health scale, the self rating Depression Scale (SDS), the self rating Anxiety Scale (SAS) and the social support rating scale (SSRS) were used to investigate 103 renal transplant donors. The score of the SF-36 concise health scale, the SDS score, the SAS score and the reference value of the normal reference group were compared in order to understand the renal transplantation. The quality of life and the status of mental health of the donors were analyzed by Pearson and Spearman correlation analysis, multiple regression analysis and case control study to analyze the factors affecting the quality of life and mental health of donors in renal transplantation.
Results: 1. the total scores of emotional function, mental state, vitality and health were higher than those of normal model (P0.05) in 8 dimensions of life quality after renal transplantation. The mental health status and social support were better than those of normal people (P0.05).
2. the correlation analysis showed that age and quality of life were negatively correlated with physiological function, physiological function, emotional function, social function, pain, vitality and mental state (P0.05), suggesting that the quality of life of older donors was poor, and the total evaluation of gender and physiological function, emotional function, vitality and health was negatively correlated (P0.05), suggesting male donors. The physiological status and mental health were better; the 8 dimensions of the donor relationship and the quality of life were negatively correlated (P0.05), suggesting that the closer the relationship was, the worse the quality of life was, and the cultural level was positively correlated with physiological function, physiological function, social function, pain, vitality, mental state and health assessment price (P0.05), suggesting a higher level of cultural level. The overall evaluation of marriage and health, physiological function and vitality were negatively correlated (P0.05), suggesting that the overall health of the unmarried donors was better, and the postoperative time was positively correlated with the overall health evaluation and physiological function (P0.05), suggesting that the better the health status was, the better the health status was, the economic status was positively related to physiological function, physiological function and pain (P0.05). The results showed that the function and function of the donors with better economic status were better, the self rating depression score (SDS) and the self rating anxiety score (SAS) were negatively correlated with the 8 dimensions of quality of life (P0.05), suggesting that the quality of life of the donors with anxiety and depression was poor, social support, subjective support score, social support utilization and donor operation. The 8 dimensions of quality of life were positively correlated (P0.05), suggesting that the higher the social support, the better the quality of life of the donor.
Age, the relationship between the donor and the donor was positively correlated with depression and anxiety score (P0.05), suggesting that the elderly and the closely related donors were poor in mental health; marriage, gender and anxiety score had a positive correlation (P0.05), suggesting that married, female donors were prone to anxiety; economic status, educational level, social support and depression, and anxiety scores negatively correlated (P0.05), suggesting social classics. The mental health status of donors with better social support was better.
The objective score of gender and social support was negatively correlated (P0.05), suggesting that the objective score of social support was higher; the relationship and social support of the recipient, the objective score of social support, the subjective score of social support and the social support utilization were negatively correlated (P0.05), the closer the relationship was, the worse the social support was, and the cultural level and social support. The degree of utilization was positively correlated (P0.05), and the higher the degree of social support was, the higher the social support utilization was.
3. multiple regression showed that the psychological health status (especially anxiety) of the donor, and social support (especially the subjective score and utilization) were the most important factors in the quality of life and all aspects of mental health; the post operation depression and anxiety score were mainly influenced by the social support and the influence of the donor relationship; the donor relationship was the shadow. The biggest factor in social support for the donors after the operation.
Conclusion: 1. in China, the donor of renal transplantation mainly comes from rural, aged, female, low cultural and low economic level, which is closely related to relatives, and the quality of life and mental health of this part of the donor is relatively poor.
2. the social life events that may affect the mental health of the donor are in turn: the health of the recipients, the family economic problems of the recipients, the function of the renal transplantation after renal transplantation, the family economic status of the donors, the health of the donors, and the influence of the solitary kidney after the removal of the kidney on the future life and work.
3. the quality of life, mental health and social support of kidney transplant recipients were better than those of the general population.
4. there are many factors affecting the quality of life of the donor, mainly affected by mental health (especially anxiety), and social support (especially subjective score and utilization).
5. the mental health of donors was mainly affected by social support and relationship between donors and recipients.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R699;R395

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