关键词: 肾移植, 焦虑, 抑郁, 疲乏, 健康状况, 纵向研究

Abstract:

Objective To investigate the anxiety,depression and fatigue in patients after renal transplant in one month（T1）,six months（T2） and one year（T3）,and to explore their impact on health status. Methods A longitudinal study was conducted among 180 patients admitted to the department of organ transplantation of a tertiary hospital for renal transplantation from May 2016 to June 2018. The questionnaire included general information questionnaire,Patient Health Questionnaire-9（PHQ-9）,Generalized Anxiety Disorder-7（GAD-7）,the Multi-dimensional Fatigue Inventory（MFI） and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire（EORTC-QLQ-C30）. Results ①The incidence of anxiety at T1,T2,T3 was 28.9%,29.4%,33.9%,and depression was 39.4%,36.3%,37.8%,severe fatigue was 14.4%,11.3%,and 14.3%,respectively. ②There was no statistically significant change in anxiety and depression scores after kidney transplantation（P>0.05）,however,fatigue scores decreased over time（F=7.667,P<0.001）,and overall health status scores decreased significantly one year after kidney transplantation（F=3.746,P<0.028）. ③The results of the generalized estimation equation showed that depression negatively affected the overall postoperative health status（Wald χ ²=21.155,P<0.001）.④Sensitivity analysis showed that results of multiple imputation and deletion were consistent,and depression could still predict the overall health status（Wald χ ²=12.386,P<0.001）. Conclusion The incidence rates of anxiety,depression and severe fatigue were 33.9%,37.8%,and 14.3%,respectively one year after transplantation. The overall health status at T3 was lower than that at T1 and T2. Depression can negatively affect postoperative health status,which should be concerned by health care workers.

Key words: Kidney Transplantation, Anxiety, Depression, Fatigue, Health status, Longitudinal Studies