肾移植受者恐惧疾病进展现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2022.01.011

摘要/Abstract

摘要：

目的调查肾移植受者的恐惧疾病进展情况,并分析其影响因素。方法采用便利抽样方法,于2021年2月—6月选取长沙市某三级甲等医院221例肾移植受者为调查对象,采用一般资料调查表、中文版恐惧疾病进展简化量表、积极心理资本问卷、简易版疾病感知问卷和中文版痛苦表露指数量表进行问卷调查。结果肾移植受者中文版恐惧疾病进展简化量表得分为 (28.13±7.87) 分,≥34分者51例 (23.08%),积极心理资本问卷得分为 (124.05±21.06) 分,简易版疾病感知问卷得分为 (37.67±11.10) 分,中文版痛苦表露指数量表得分为 (36.09±8.98) 分。多元线性回归分析显示,简易版疾病感知问卷得分 (β=0.527,P<0.001) 和积极心理资本问卷得分 (β=-0.135,P=0.043) 是肾移植受者恐惧疾病进展的影响因素,共解释35.3%的总变异。结论肾移植受者的恐惧疾病进展发生率较高,总体处于中等水平,临床工作者应重视肾移植受者的心理状况,改善患者的疾病感知,增强患者的积极心理资本,以降低其恐惧疾病进展水平。

关键词: 肾移植, 恐惧疾病进展, 心理资本, 疾病感知, 自我表露, 护理

Abstract:

Objective To investigate the status and factors associated with fear of progression in recipients of renal transplantation. Methods By using the convenient sampling method,221 recipients of renal transplantations were selected from February to June 2021 in a tertiary hospital in Changsha. General information questionnaire,Fear of Progression Questionnaire-Short Form,Positive Psychological Capital Questionnaire,Brief Illness Perception Questionnaire,Distress Disclosure Index were used to conduct the investigation. Results The score of fear of progression of recipients of renal transplantation was (28.13±7.87) ;51 cases (23.08%) were≥34 points;the positive psychological capital score was (124.05±21.06) ;the illness perception score was (37.67±11.10) ;the distress disclosure score was (36.09±8.98). Multiple linear regression analysis showed that illness perception and positive psychological capital were the influencing factors of fear of progression (P<0.05),which explained 35.3% of the total variation. Conclusion The incidence of fear of progression in recipients of renal transplantation is high,which is generally in the middle level. Clinicians should pay attention to the psychological status of renal transplant recipients,and reduce recipients’ illness perception,enhance patients’ positive psychological capital,and reduce their fear of disease progression.

Key words: Kidney Transplantation, Fear of Progression, Positive Psychological Capital, Illness Perception, Distress Disclosure, Nursing Care

林韦彤, 刘立芳, 万晶晶, 刘晶晶, 杨梦, 马航霞. 肾移植受者恐惧疾病进展现状及影响因素研究[J]. 中华护理杂志, 2022, 57(1): 73-78.

LIN Weitong, LIU Lifang, WAN Jingjing, LIU Jingjing, YANG Meng, MA Hangxia. The status and factors associated with fear of progression in recipients of renal transplantation[J]. Chinese Journal of Nursing, 2022, 57(1): 73-78.

图/表 3

表1 肾移植受者的一般资料及恐惧疾病进展的单因素分析 (n=221)

Table 1 Univariate analysis of the general information on the fear of progression (n=221)

表2 肾移植受者的中文版恐惧疾病进展简化量表、积极心理资本问卷、简易版疾病感知问卷以及中文版痛苦表露指数量表得分情况 (n=221)

Table 2 The scores of fear of progression,positive psychological capital,brief illness perception and distress disclosure of recipients of renal transplantation (n=221)

表3 肾移植受者恐惧疾病进展相关因素的多元线性回归分析

Table 3 Multiple linear regression analysis of related factors of fear of progression

参考文献 22

[1]	Dankert A, Duran G, Engst-Hastreiter U, et al. Fear of progression in patients with cancer,diabetes mellitus and chronic arth-ritis[J]. Rehabili(Stuttg), 2003, 42(3):155-163.
[2]	吴奇云, 叶志霞, 李丽, 等. 癌症患者恐惧疾病进展简化量表的汉化及信效度分析[J]. 中华护理杂志, 2015, 50(12):1515-1519.
	Wu QY, Ye ZX, Li L, et al. Reliability and validity of Chinese version of Fear of Progression Questionnaire-Short Form for cancer patients[J]. Chin J Nurs, 2015, 50(12):1515-1519.
[3]	El-Husseini A, Aghil A, Ramirez J, et al. Outcome of kidney transplant in primary,repeat,and kidney-after-nonrenal solid-organ transplantation:15-year analysis of recent UNOS database[J]. Clin Transplant, 2017, 31(11):e13108.
[4]	Low JK, Crawford K, Manias E, et al. Stressors and coping resources of Australian kidney transplant recipients related to medication taking:a qualitative study[J]. J Clin Nurs, 2017, 26(11/12):1495-1507. DOI URL
[5]	王佳佳, 方艳春, 王蓉, 等. 心理资本在乳腺癌患者知觉压力与癌症复发恐惧间的中介效应[J]. 护理学杂志, 2021, 36(1):76-79.
	Wang JJ, Fang YC, Wang R, et al. Mediating effect of psychological capital on the relationship between perceived stress and fear of cancer recurrence in breast cancer patients[J]. J Nurs Sci, 2021, 36(1):76-79.
[6]	王乾沙, 魏清风, 钟清玲, 等. 肺癌患者癌症复发恐惧现状及影响因素研究[J]. 中国护理管理, 2020, 20(10):1596-1600.
	Wang QS, Wei QF, Zhong QL, et al. Study on influencing factors of fear of cancer recurrence in lung cancer patients[J]. Chin Nurs Manag, 2020, 20(10):1596-1600.
[7]	张贤贤, 张利霞, 贾智慧, 等. 夫妻自我表露在青年乳腺癌患者癌症复发恐惧干预中的应用研究[J]. 中华护理杂志, 2019, 54(11):1610-1614.
	Zhang XX, Zhang LX, Jia ZH, et al. Application and effect eva-luation of marital self-disclosure intervention on the fear of cancer recurrence in young breast cancer patients[J]. Chin J Nurs, 2019, 54(11):1610-1614.
[8]	Mehnert A, Herschbach P, Berg P, et al. Fear of progression in breast cancer patients-validation of the short form of the Fear of Progression Questionnaire(FoP-Q-SF)[J]. Z Psychosom Med Psychother, 2006, 52(3):274-288.
[9]	张阔, 张赛, 董颖红. 积极心理资本:测量及其与心理健康的关系[J]. 心理与行为研究, 2010, 8(1):58-64.
	Zhang K, Zhang S, Dong YH. Positive psychological capital:measurement and relationship with mental health[J]. Stud Psyc Beha, 2010, 8(1):58-64.
[10]	Broadbent E, Petrie KJ, Main J, et al. The Brief Illness Perception Questionnaire[J]. J Psychosom Res, 2006, 60(6):631-637. DOI URL
[11]	梅雅琪, 李惠萍, 杨娅娟, 等. 中文版疾病感知问卷简化版在女性乳腺癌患者中的信效度检验[J]. 护理学报, 2015, 22(24):11-14.
	Mei YQ, Li HP, Yang YJ, et al. Reliability and validity of Chinese version of the Brief Illness Perception Questionnaire in patients with breast cancer[J]. J Nurs, 2015, 22(24):11-14.
[12]	Kahn JH, Hessling RM. Measuring the tendency to conceal versus disclose psychological distress[J]. J Soci Clini Psychol, 2001, 20(1):41-65.
[13]	李新民. 大学生成人依恋、自我表露与抑郁状态的关系研究[D]. 石家庄:河北师范大学, 2009.
	Li XM. Research on the relationship between adult attach-ment,self-disclosure and depression of college students[D]. Shi-jiazhuang:Hebei Normal University, 2009.
[14]	王小平, 何芳, 祝凡, 等. 膀胱癌术后患者恐惧疾病进展现状及影响因素研究[J]. 护理学杂志, 2019, 34(2):52-55.
	Wang XP, He F, Zhu F, et al. The level and factors associated with fear of progression in patients after bladder cancer surgery[J]. J Nurs Sci, 2019, 34(2):52-55.
[15]	李艳艳, 单岩, 杜理平, 等. 慢性肾脏病患者疾病感知与恐惧疾病进展的相关性研究[J]. 中国健康教育, 2019, 35(3):258-261.
	Li YY, Shan Y, Du LP, et al. Correlation between illness perception and fear of progression in patients with chronic kidney disease[J]. Chin J Healt Educ, 2019, 35(3):258-261.
[16]	Krebs J, Wasner S, Egloffstein S, et al. Resilience,fear of pro-gression and psychosocial distress in patients with breast cancer and gynecological tumors seeking a second opinion[J]. Psychother Psychosom Med Psychol, 2019, 69(7):293-300. DOI URL
[17]	Muscat P, Weinman J, Farrugia E, et al. Illness perceptions pre-dict mortality in patients with predialysis chronic kidney di-sease:a prospective observational study[J]. BMC Nephrol, 2020, 21(1):537. DOI URL
[18]	Shim EJ, Lee JW, Min YH. Does depression decrease the moderating effect of self-efficacy in the relationship between illness perception and fear of progression in breast cancer?[J]. Psychooncology, 2018, 27(2):539-547. DOI URL
[19]	Krok D, Telka E, Zarzycka B. Illness perception and affective symptoms in gastrointestinal cancer patients:a moderated mediation analysis of meaning in life and coping[J]. Psychooncology, 2019, 28(8):1728-1734. DOI URL
[20]	黄丽洁, 王飞杰, 张海鑫, 等. 心理资本在农村空巢老年人孤独感与抑郁间的中介作用分析[J]. 中国卫生统计, 2021, 38(2):280-282.
	Huang LJ, Wang FJ, Zhang HX, et al. An analysis of the mediating role of psychological capital between loneliness and depression of empty-nest elderly in rural areas[J]. Chin J Heal Stat, 2021, 38(2):280-282.
[21]	李文静, 康凤英, 田伟, 等. 化疗期乳腺癌患者的正念癌症康复干预研究[J]. 中华护理教育, 2020, 17(7):653-658.
	Li WJ, Kang FY, Tian W, et al. The mindfulness-based cancer recovery for patients with breast cancer during chemotherapy[J]. Chin J Nurs Educ, 2020, 17(7):653-658.
[22]	弓儒芳, 刘均娥, 王秋莉. 接纳承诺疗法对口腔癌复发患者癌症复发恐惧的影响[J]. 护理学杂志, 2019, 34(16):84-86.
	Gong RF, Liu JE, Wang QL. Effect of acceptance and commitment therapy on fear of cancer recurrence among recurrent oral cancer patients[J]. J Nurs Sci, 2019, 34(16):84-86.