Patients waiting for a liver transplantation from the perspective of psychological resilience：a qualitative study

doi:10.3761/j.issn.0254-1769.2025.15.011

Abstract

Abstract:

Objective To explore the psychological feelings and coping resources of patients waiting for a liver transplantation，in order to provide references for implementing psychological nursing care. Methods Using purposive sampling，15 patients waiting liver transplantation surgery from June to November 2024 at a tertiary hospital in Qingdao were selected as study subjects. Semi-structured in-depth interviews were conducted，and data were analyzed using interpretative phenomenological analysis to extract themes. Results The psychological feelings of patients waiting for a liver transplantation included 2 main themes with 6 sub-themes，namely，the complex and contradictory psychological feelings of liver transplant patients during the waiting period（expectations for transplanta-tion and future outlook，multiple psychological burdens intertwining，introspection and growth），and mobilizing psychological resilience resources to deal with complex psychological feelings（core resources，internal resources，external resources）. Conclusion Clinical medical staff should implement psychological care for patients waiting for a liver transplantation based on the complex and contradictory psychological feelings they experience. Also，they should target the coping resources for psychological feelings to construct coping strategies，thereby comprehensively improving patients’ psychological health during the waiting period. The coping strategies include promoting patients’ health behaviors, improving their psychological status, and providing multidimensional social support for them.

Key words: Liver Transplantation, Waiting Period, Resilience, Psychological Feeling, Coping Resource, Qualitative Study, Nursing Care

摘要：

目的在心理弹性视角下，探究肝移植患者等待期心理感受及应对资源，为提高其心理健康水平提供参考。方法采用目的抽样法，于2024年6—11月选取在青岛市某三级甲等医院肝脏移植病区等待肝移植手术的15例患者作为研究对象，以多系统心理弹性模型为框架，对其进行半结构式访谈，并采用解释现象学研究法对资料进行分析与主题提炼。结果归纳出2个主题和6个亚主题，即肝移植患者等待期复杂矛盾的心理感受（期待手术并憧憬未来、多重心理负担交织、内省与获得成长）、调动心理弹性资源以应对复杂心理感受（核心层资源、内部层资源、外部层资源）。结论护士应以肝移植患者等待期存在的复杂矛盾的心理感受为导向实施心理护理，并以心理弹性资源为靶点，通过促进患者健康行为、优化其心理特质和提供多元化社会支持，综合提升患者等待期心理健康水平，提高生活质量。

关键词: 肝移植, 等待期, 心理弹性, 心理感受, 应对资源, 质性研究, 护理

WANG Jiamin, ZHOU Dan, ZHOU Yinghao, SONG Lei, ZHANG Bingliang, GONG Yufei, ZHAO Lin. Patients waiting for a liver transplantation from the perspective of psychological resilience：a qualitative study[J]. Chinese Journal of Nursing, 2025, 60(15): 1864-1870.

王家敏, 周丹, 周莹皓, 宋蕾, 张丙良, 宫羽菲, 赵林. 肝移植患者等待期心理感受及应对资源的质性研究[J]. 中华护理杂志, 2025, 60(15): 1864-1870.

Figures/Tables 1

References 26

[1]	窦科峰, 张玄, 杨志鹏. 中国肝移植的发展与挑战[J]. 中华外科杂志, 2024, 62(1):1-5.
	Dou KF, Zhang X, Yang ZP. Developments and challenges of liver transplantation in China[J]. Chin J Surg, 2024, 62(1):1-5.
[2]	王芳菲, 贺强. 2023年中国肝移植临床研究年度盘点[J]. 器官移植, 2024, 15(3):377-382.
	Wang FF, He Q. Highlights of clinical research on liver trans-plantation in China of 2023[J]. Organ Transplant, 2024, 15(3):377-382.
[3]	Gao SY, Wen SL, Lu YF, et al. Mental health of recipients after cadaveric liver transplantation:a perspective from positive psy-chology[J]. J Clin Nurs, 2023, 32(15/16):4710-4718.
[4]	吴政东. 心理弹性的研究方法及神经机制[J]. 心理学进展, 2024(3):30-36.
	Wu ZD. The research methods and neural mechanism of psychological resilience[J]. Adv Psychol, 2024(3):30-36.
[5]	Liu JJW, Reed M, Girard TA. Advancing resilience:an integra-tive,multi-system model of resilience[J]. Pers Individ Differ, 2017,111:111-118.
[6]	郭利敏, 李乐之, 卢彦芳, 等. 自我效能在肝移植受者社会支持与心理弹性间的中介效应[J]. 中华护理教育, 2021, 18(2):173-178.
	Guo LM, Li LZ, Lu YF, et al. The mediating effect of self-efficacy on the relationship between social support and psy-chological resilience in liver transplant recipients[J]. Chin J Nurs Educ, 2021, 18(2):173-178.
[7]	郑静静, 郑亚华, 张黎. 肝移植受者移植等候期的心理体验[J]. 中国护理管理, 2022, 22(1):57-62.
	Zheng JJ, Zheng YH, Zhang L. Psychological experience of liver transplant recipients in the waiting period[J]. Chin Nurs Manag, 2022, 22(1):57-62.
[8]	高犇, 代星, 李江. 改良查尔森合并症指数对老年患者肝移植术后早期并发症的评估价值[J]. 天津医科大学学报, 2023, 29(2):178-182.
	Gao B, Dai X, Li J. Evaluation of the modified Charlson Comorbidity Index for predicting early complications after liver transplantation in elderly patients[J]. J Tianjin Med Univ, 2023, 29(2):178-182.
[9]	祖泽元, 方美欣, 吴思衡, 等. 接纳承诺疗法对孤独症儿童母亲情绪、认知、行为的改善:基于解释现象学研究[J]. 中国临床心理学杂志, 2023, 31(6):1500-1509.
	Zu ZY, Fang MX, Wu SH, et al. An interpretive phenomeno-logical analysis study:acceptance commitment therapy impro-ves outcomes for mothers of children with autism[J]. Chin J Clin Psychol, 2023, 31(6):1500-1509.
[10]	Ma RS, Liu T, Sum KWR, et al. Relationship among physical literacy,mental health,and resilience in college students[J]. Front Psychiatry, 2021,12:767804.
[11]	韩梦汐, 王晗, 王莎莎, 等. 肝移植受者心理一致感与疾病认知的相关性研究[J]. 解放军护理杂志, 2019, 36(12):49-52.
	Han MX, Wang H, Wang SS, et al. Relationship between sense of coherence and illness perception in liver transplant reci-pients[J]. Nurs J Chin PLA, 2019, 36(12):49-52.
[12]	王乐琦. 基于Gross情绪调节理论的职业女性减压产品设计研究[D]. 青岛: 青岛理工大学, 2024.
	Wang LQ. Research on the design of professional women’s decompression products based on gross’s emotional regulation theory[D]. Qingdao: Qingdao University of Technology, 2024.
[13]	王效, 谢娟, 王雁, 等. 乳腺癌病人疾病获益感、大五人格与生命质量的关系[J]. 护理研究, 2024, 38(19):3423-3428.
	Wang X, Xie J, Wang Y, et al. Relationship between disease sense of benefit,big five personality and quality of life in breast cancer patients[J]. Chin Nurs Res, 2024, 38(19):3423-3428.
[14]	孙慧慧, 张丙良, 娄连玉, 等. 肝移植患者术前预康复方案的构建[J]. 中华护理杂志, 2023, 58(18):2195-2202. DOI
	Sun HH, Zhang BL, Lou LY, et al. Construction of a preopera-tive prehabilitation program for liver transplant recipients[J]. Chin J Nurs, 2023, 58(18):2195-2202.
[15]	叶金婵. 基于拓展建构理论的感恩干预对恶性淋巴瘤化疗期患者尊严水平的影响研究[D]. 乌鲁木齐: 新疆医科大学, 2022.
	Ye JC. The influence of gratitude intervention on the dignity level of patients with malignant lymphoma[D]. Urumqi: Xin-jiang Medical University, 2022.
[16]	Bogliacino F, Codagnone C, Montealegre F, et al. Negative shocks predict change in cognitive function and preferences:assess-ing the negative affect and stress hypothesis[J]. Sci Rep, 2021, 11(1):3546. DOI PMID
[17]	王玉霞, 徐亦虹, 唐心怡, 等. 再次肾移植等待期患者心理体验的质性研究[J]. 中华护理杂志, 2023, 58(18):2189-2194. DOI
	Wang YX, Xu YH, Tang XY, et al. A qualitative study of the psychological experience of patients waiting for a second kidney transplantation[J]. Chin J Nurs, 2023, 58(18):2189-2194. DOI
[18]	李洁, 孙艺华, 王璟铭. 丧亲者的内疚感能促进创伤后成长吗:一把双刃剑[J]. 中国临床心理学杂志, 2021, 29(1):93-97.
	Li J, Sun YH, Wang JM. Can guilt in bereavement lead to posttraumatic growth:the double-sword effect of guilt in pro-moting posttraumatic growth among the bereaved[J]. Chin J Clin Psychol, 2021, 29(1):93-97.
[19]	Guo Z, Chen Y, Zhang Y, et al. Associations among risk per-ception,health efficacy,and health behaviors for cardiovas-cular disease:an application of risk perception attitude frame-work[J]. Front Cardiovasc Med, 2023,10:1201789.
[20]	Gençdal G, Türker G, Gençdal IY, et al. Assessment of sleep pattern and quality before and after liver transplantation using different methods[J]. 2020, 31(8):581-587.
[21]	Arora T, Grey I, Östlundh L, et al. A systematic review and meta-analysis to assess the relationship between sleep dura-tion/quality,mental toughness and resilience amongst healthy individuals[J]. Sleep Med Rev, 2022,62:101593.
[22]	程岚, 吴奕帆, 王汇, 等. 基于认知行为理论构建肺癌病人戒烟管理方案[J]. 护理研究, 2023, 37(17):3099-3105.
	Cheng L, Wu YF, Wang H, et al. Construction of smoking cessation management program for lung cancer patients based on cognitive behavior theory[J]. Chin Nurs Res, 2023, 37(17):3099-3105.
[23]	赵洋洋, 潘文彦, 周子琳, 等. 肝移植受者支持性照护需求的质性研究[J]. 中华护理杂志, 2023, 58(22):2741-2746. DOI
	Zhao YY, Pan WY, Zhou ZL, et al. A qualitative study on the specific supportive care needs of liver transplantation reci-pients[J]. Chin J Nurs, 2023, 58(22):2741-2746.
[24]	Thuluvath AJ, Siddiqui O, Lai JC, et al. Personality traits in patients with cirrhosis are different from those of the general population and impact likelihood of liver transplantation[J]. Transplantation, 2023, 107(2):420-428.
[25]	Medina-Craven MN, Ostermeier K, Sigdyal P, et al. Personality research in the 21st century:new developments and direc-tions for the field[J]. J Manag Hist, 2023, 29(2):276-304.
[26]	贾立红, 孙晓红, 殷涵, 等. 新入职护士叙事护理知识-态度-行为的调查研究[J]. 中华护理教育, 2021, 18(8):732-735.
	Jia LH, Sun XH, Yin H, et al. The knowledge,attitude and behavior related to narrative nursing of new nurses[J]. Chin J Nurs Educ, 2021, 18(8):732-735.