新型冠状病毒肺炎暴发期间肝移植受者服药依从性与生命质量调查研究

肝脏 ›› 2021, Vol. 26 ›› Issue (6): 655-660.

新型冠状病毒肺炎暴发期间肝移植受者服药依从性与生命质量调查研究

贾丽燕, 景懿磊, 张千, 吕晓颖, 吴新瑞, 马方晖, 刘雯琼, 薛峰, 朱燕波

100029 北京中医药大学中医学院(贾丽燕,张千,吕晓颖),管理学院(吴新瑞,马方晖,刘雯琼,朱燕波);上海交通大学医学院附属仁济医院肝脏外科(景懿磊,薛峰)

收稿日期:2020-10-26 出版日期:2021-06-30 发布日期:2021-07-19
通讯作者: 朱燕波,Email: yanbo0722@sina.com;薛峰,Email: fengxue6879@163.com
作者简介:共同第一作者:景懿磊
基金资助:
“十三五”国家科技重大专项课题(2018ZX10723203-003-003);国家社科基金国家应急管理体系建设研究专项(20VYJ046)

Investigation on medication adherence and quality of life of liver transplant recipients in a hospital in Shanghai during the outbreak of novel coronavirus pneumonia

JIA Li-yan¹, JING Yi-lei², ZHANG Qian¹, LV Xiao-ying¹, WU Xin-rui³, MA Fang-hui³, LIU Wen-qiong³, XUE Feng², ZHU Yan-bo³

1. School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;
2. Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;
3. School of Management, Beijing University of Chinese Medicine, Beijing 100029, China

Received:2020-10-26 Online:2021-06-30 Published:2021-07-19
Contact: ZHU Yan-bo,Email: yanbo0722@sina.com;XUE Feng,Email: fengxue6879@163.com

摘要/Abstract

摘要： 目的调查新型冠状病毒肺炎(COVID-19)暴发期间肝移植受者服药依从性及生命质量,为今后突发公共卫生事件发生时对肝移植受者的健康管理提供依据。方法 2020年2月17日至2月21日对长期随诊于上海交通大学医学院附属仁济医院的183例成人肝移植受者进行问卷调查。问卷由一般资料、免疫抑制剂治疗依从性Basel评估量表(BAASIS)及肝移植后生活质量调查问卷(pLTQ)组成。经数据分析获得疫情期间肝移植受者服药依从性及生命质量情况,并通过多元线性回归分析探讨二者的影响因素。结果 180例样本纳入分析。肝移植受者服药依从性得分为(5.25 ± 2.26)分,57.22%(103/180)受者依从性好;生命质量得分为(146.51 ± 29.73)分。患者服药依从性的影响因素为术后未能正常工作(b’=-0.192, P= 0.008)、术后时间长(b’= 0.188, P= 0.009)、少数民族(b’= 0.186, P= 0.010)。患者生命质量的影响因素为睡眠质量差(b’=-0.252, P<0.01)、家庭人均月收入高(b’=0.212, P= 0.003)、术后时间长(b’= 0.177, P= 0.009)、术后未能正常工作(b’= -0.150, P= 0.036)。结论疫情期间肝移植受者的服药依从性较好、生命质量未受到明显影响。但术后正常工作、术后时间长和少数民族对服药依从性的负向影响,睡眠质量差、收入低、术后时间短、术后未能正常工作对生命质量的负向影响,临床中应引起充分重视。

关键词: 新型冠状病毒肺炎, 肝移植, 服药依从性, 生命质量, 影响因素

Abstract: Objective To investigate the medication adherence and quality of life in adult liver transplant (LT) recipients during the epidemic of 2019 novel coronavirus pneumonia (COVID-19) in China and to provide guidance for health management of LT recipients in the face of public health emergencies.Methods A cross-sectional survey was conducted among 183 cases of adult LT recipients followed up in our hospital from 17th to 21st February 2020. The questionnaire consisted of self-designed general data questionnaire, the Basel Assessment of Adherence Immunosuppressive Medications Scale (BAASIS) and post-liver transplant quality of life (pLTQ). The data was analyzed to investigate the medication adherence and quality of life of LT recipients during the COVID-19 pandemic, and the influencing factors were analyzed by multiple linear regression analysis.Results One hundred and eighty samples were included in the analysis. ① The BAASIS score of medication adherence was (5.25 ± 2.26) points, and the pLTQ score of quality of life was (146.51 ± 29.73) point. Among all the recipients, 57.22% were with good medication adherence.② The independent influencing factors of the medication adherence in LT recipients included “unemployment after surgery” (b'=-0.192, P=0.008), “long survival time” (b'=0.188, P=0.009), and “minority nationality” (b'=0.186, P=0.010). ③ The independent influencing factors of life quality in LT recipients included “poor sleep quality” (b'=-0.252, P=0.000), “high monthly per capita income” (b'=0.212, P=0.003), “long survival time” (b'=0.177, P=0.009), and “unemployment after the surgery” (b'=-0.150, P=0.036).Conclusion The medication adherence of LT recipients was better during the COVID-19 pandemic than normal period, and the quality of life was not significantly affected. However, employment after operation, long survival time and minority nationality played negative effects on patients’ medication adherence. And poor sleep quality, low income, short survival time, and unemployment after operation played negative effects on patients’ quality of life. Patients with these features need more attention, targeted guidance and nursing intervention.

Key words: Novel coronavirus pneumonia, Liver transplant, Medication adherence, Quality of life, Influencing factors

贾丽燕, 景懿磊, 张千, 吕晓颖, 吴新瑞, 马方晖, 刘雯琼, 薛峰, 朱燕波. 新型冠状病毒肺炎暴发期间肝移植受者服药依从性与生命质量调查研究[J]. 肝脏, 2021, 26(6): 655-660.

JIA Li-yan, JING Yi-lei, ZHANG Qian, LV Xiao-ying, WU Xin-rui, MA Fang-hui, LIU Wen-qiong, XUE Feng, ZHU Yan-bo. Investigation on medication adherence and quality of life of liver transplant recipients in a hospital in Shanghai during the outbreak of novel coronavirus pneumonia[J]. Chinese Hepatolgy, 2021, 26(6): 655-660.

参考文献

[1] Mayank J, Jayanthi V, Mettu SR, et al. Determinants of medication adherence in liver transplant recipients. J Clin Exp Hepatol, 2019, 9: 676-683.
[2] 吴蓉,莫萍,姜佳慧,等. 新型冠状病毒肺炎疫情下炎症性肠病患者诊疗情况及心理状态问卷调查. 胃肠病学和肝病学杂志, 2020, 29: 654-659.
[3] Fabienne D, Lut B, Sabina DG, et al. The psychometric properties and practicability of self-report instruments to identify medication nonadherence in adult transplant patients: a systematic review. Transplantation, 2010, 90: 205-219.
[4] 刘佳,谢建飞,刘立芳,等. 基于微信的同伴教育对肝移植受者服药依从性及生活质量的影响. 中华器官移植杂志, 2019, 40: 484-488.
[5] Sammy S, Vivian N, Carmen L, et al. Development of a disease-specific questionnaire to measure health-related quality of life in liver transplant recipients. Liver Transpl, 2011,17: 567-579.
[6] 彭晓,牛玉坚,石红娟,等. 中文版肝移植受者生活质量调查问卷的信效度研究. 护理学杂志, 2015, 30: 28-31.
[7] 吴丝丝,杜春燕,胡阅,等. 成人肝移植受者服药依从性现状及其对生活质量的影响. 护理研究, 2017, 31: 4669-4672.
[8] 尚雅彬,刘红霞,王璐,等. 肝移植受者免疫抑制药物依从性现状调查及分析. 中国护理管理, 2017, 17: 542-547.
[9] 中华医学会器官移植学分会. 新型冠状病毒肺炎疫情期间全国器官捐献与移植工作的指导原则. 器官移植, 2020, 11: 179-184.
[10] 崔恒,王雪瑞,傅巧美,等. 新型冠状病毒肺炎疫情期间肝移植病人的居家护理. 护理研究, 2020, 34: 741-743.
[11] 薛召,朱皓阳,胡良硕,等. 移动医疗技术在器官移植受体术后管理中的应用进展. 器官移植, 2018, 9: 319-321.
[12] 周海英,章琪,王燕,等. 肝移植术后病人出院后生活质量现状及影响因素的调查分析. 全科护理, 2019, 17: 3217-3221.
[13] 王颖,赵楠,王旭,等. 肝肾联合移植术后健康教育随访策略. 器官移植, 2016, 7: 227-229.
[14] Zhu X, Ming YZ, Liu J, et al. Sleep quality and psychosocial factors in liver transplant recipients at an outpatient follow-up clinic in China. Ann Transplant, 2020, 25: e920984.
[15] Nicholas JS, James B, Daniel CO, et al. Financial burden of liver transplant vs resection for hepatocellular carcinoma. Transplant Proc, 2019, 51: 1907-1912.