Correlation Of Psychological State,social Support And Quality Of Life in Kidney Transplant Recipients JIANG Chunying,XIAO Jiansheng,WANG Xiaofeng,XIAO Qi
Jan 11, 2023
Abstract
OBJECTIVE:To explore the relationship between psychological status, social support, and quality of life in renal transplant recipients and to provide a basis for the development of targeted medical care measures.
Methods:The anxiety self-assessment Self-Assessment Scale (SAS), Self-Rating Depression Scale (SDS), Brief Health Status Questionnaire (SF⁃36) and Social Support Scale (SSRS) were used to investigate 244 renal transplant recipients.
Results:The SAS scores of renal SAS score (45. 79±7. 52), SDS score (49. 20±10. 56), and SSRS total score (39. 57±7. 99) were significantly higher than those of the domestic norm (P<0.05).(p<0. 05). There was a negative correlation (P<0.05) between the SAS and SDS scores and their SF36 scores, and a positive correlation (P<0.05) between the SSRS scores and the SF36 scores of all dimensions except the social functioning dimension.
The SSRS scores were positively correlated with the SF36 scores except for the social functioning dimension (P<0.05). Conclusion:The better the psychological status of kidney transplant recipients, the more social support they have, and the better their quality of life. Medical staff should provide information and support to kidney transplant recipients. support, intervene in their negative emotions, and encourage and guide them to make full use of social support networks and adopt positive ways of coping in order to improve their quality of life.
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Keywords renal transplant recipients; psychological status; social support; quality of life; correlation
For patients with end-stage renal disease, kidney transplantation is one of the most effective methods [1]. With the development of medicine, social progress and nationwide development of organ donation after death of citizens (CDC), more and more patients with end-stage renal disease are opting for kidney transplantation. It has been reported in the literature that in 2017, our country ranked 2nd in the world with more than 10,000 kidney transplantation procedures [2]. Kidney transplantation has freed patients from the threat of death and long-term hemodialysis treatment, and their condition has improved and stabilized. However, due to the torture of long-term chronic kidney disease, the trauma of surgery, the financial burden caused by the cost of surgical treatment, and the side effects of long-term immunosuppressive therapy required after kidney transplantation
However, due to long-term chronic kidney disease, surgical trauma, the financial burden of surgical treatment costs, and side effects of long-term immunosuppressive therapy after kidney transplantation, post-transplant kidney transplant recipients (KTRs) develop various mental health problems [3⁃5] These mental health problems seriously affect the quality of life and survival rate of kidney transplant recipients. Social support refers to the help available to individuals in stressful situations [7] that can provide It provides safety and protection for the individual. The aim of this study was to understand the psychological status, social support and quality of life of kidney transplant recipients. The purpose of this study is to understand the relationship between psychological status, social support, and quality of life of kidney transplant recipients, and to develop targeted medical care measures to improve The aim of this study was to understand the relationship between psychological status, social support and quality of life of kidney transplant recipients, and to provide guidance and reference for the development of targeted medical care measures to improve the psychological health and quality of life of The purpose of this study is to understand the relationship between psychological status, social support and quality of life of kidney transplant recipients.
1 Object and Method
1. 1 Subjects 244 kidney transplant recipients who were followed up in our outpatient department from October 9, 2020 to November 6, 2020 were selected for the study. Among them, 147 were males and 97 were females; the source of kidneys: 14 cases between relatives and 230 cases between non-relatives. Inclusion criteria: ① age ≥ 18 years; time ≥ 1 month after receiving kidney transplantation and normal function of the transplanted kidney; ② no serious complications of important organs; ③ clear consciousness; ability to read and understand words; ④ owning a smartphone and being able to use WeChat function; ⑤ all voluntarily participated in the survey. Exclusion criteria: ① those with mental illness or cognitive dysfunction; ② those who received more than two or two kinds of organ transplants; ③ patients who are not willing to cooperate with the survey.
1. 2 Survey tools
1.2.1 General questionnaire
Designed by the investigator, including age, gender, marital status, education level, monthly household income, payment method, financial burden, kidney source, and post-transplantation time of kidney transplant recipients.
1.2.2 Psychological status questionnaire
The anxiety self-assessment scale (SAS) and depression self-assessment scale (SDS) were used to assess the patients' subjective feelings of anxiety, and according to the Chinese normative results, a standard score <50 was considered as no anxiety, of which 50-59 was mild anxiety, 60-69 was moderate anxiety, and 69 or more was severe anxiety [9]. As a result, a standard score <53 is no depression, 53-62 is mild depression, 63-72 is moderate depression, and ≥73 is severe depression [10].
1.2.3 Brief Health Status Questionnaire (SF ⁃36)
[11] This scale contains
Physiological functioning, physical functioning, somatic pain, general health, energy, social functioning, emotional functioning, and mental health. The first 4 dimensions belong to the physiological domain and the last 4 dimensions belong to the psychological domain. The transformed score for each domain and dimension is 100, and the score for each domain is calculated by Z-transforming the corresponding dimension scores, with higher scores indicating better quality of life [12]. The Cronbach's alpha coefficient for this study was 0.783. 1.2.4 Social Support Scale (SSRS) This scale was developed by Xiao Shui Shui [13] in 1994 and includes three dimensions, subjective support (4 items), objective support (3 items), and utilization of support (3 items), with 10 items and a total score of 12-66. The higher the score, the better the social support [14]. In this study, the Cronbach's alpha coefficient was 0.773.
1. 3 Data collection method
A questionnaire was used for self-assessment by the kidney transplant recipients. The study was conducted with the consent of the kidney transplant recipients.
The survey was conducted anonymously in the form of a questionnaire star, and the items were filled out carefully after scanning the code with WeChat. For those who had difficulties in understanding the entries, the researcher explained and assisted them in filling them out, and the use of suggestive and personally inclined language was prohibited. Since the questionnaire was designed to be submitted only after each entry was completely filled in, a total of 244 questionnaires were collected, and the recovery rate was 100%.
1. 4 Statistical methods
Data were entered using Excel sheets, double-checked and logically checked for errors. SPSS 20.0 statistical software was used to analyze the data. Qualitative data were expressed as number of cases and percentage; quantitative data were expressed as mean ± standard deviation (x ± s). The t test, χ2 test, ANOVA t test, χ2 test, ANOVA, Pearson's correlation analysis, etc., and P<0.05 was used to indicate statistical significance. The differences were statistically significant.
2. 2 Social support scores for kidney transplant recipients (see Table 2)
2. 3 Quality of life scores of kidney transplant recipients and comparison with the general Chinese population norm model [16].(see Table 3)
3 SF⁃36 scores of kidney transplant recipients and comparison with the Chinese general population norm [16] Comparison of scores (x±s) Unit: score
2. 4 Univariate analysis of psychological status scores of kidney transplant recipients (see Table 4)
Table 4 Univariate analysis of psychological status scores of kidney transplant recipients (x±s) Unit: score
2.5 Correlation between psychological status, social support and quality of life in renal transplant recipients (see Table 5)
Table 5 Correlation of SAS scores, SDS scores, SSRS scores and SF⁃36 scores in renal transplant recipients (r values)
Discussion
The results of this study showed that the SAS scores of kidney transplant recipients were (45.79±7.52) and SDS scores were (49.20±10.56). (45.79±7.52) and SDS score (49.20±10.56), which were significantly (P<0.05), which is consistent with the findings of Wang Han et al [17]. The results of the study are consistent with
It indicates that the negative emotions such as anxiety and depression in kidney transplant recipients are higher than those in the domestic healthy The results were consistent with those of Wang Han et al [17], indicating that the negative emotions such as anxiety and depression were higher in kidney transplant recipients than in the domestic healthy population. The differences in SAS scores and SDS scores among renal transplant recipients with different education levels, monthly household income and economic burden were statistically significant (p< (P<0.05). The differences in SAS and SDS scores among renal transplant recipients with different education levels, monthly household income and financial burden were statistically significant (P<0.05). The reason for the lower anxiety and depression levels among kidney transplant recipients with specialized degrees and above may be due to the higher knowledge level of kidney transplant recipients with specialized degrees and above. higher level of knowledge, ability to defend against stress and self-direction They are able to overcome the psychological problems caused by the disease. The higher the monthly family income, the lower the financial burden. The higher the monthly family income and the lower the financial burden, the lower the level of anxiety and depression, which may be due to
Many patients are the breadwinners of their families because of the high cost of kidney transplantation. Many patients are the breadwinners of their families, but they cannot work normally because of the disease and have to spend a lot of money to cure the disease. Therefore, patients with high financial burden have higher levels of anxiety and depression [18]. [18]. The present study The results of this study also showed that the SAS and SDS scores of kidney transplant recipients were negatively correlated with the SF⁃36 scale scores were negatively correlated (p<0.05). Kidney transplant recipients undergo long and painful hemodialysis before transplantation. The results of the study also showed that kidney transplant recipients' SAS and SDS scores were correlated with SF⁃36 scale scores (P<0.05). The results showed that the patients had to wait for a kidney source and take immunosuppressive drugs for a long time after the transplantation. side effects of immunosuppressive drugs, acute and chronic rejection, various complications and recurrence of the original disease. The physiological and psychological health of the patients is affected for a long time due to the reasons such as the recurrence of the original disease. They are very concerned about their health status and disease regression, and their anxiety and depression levels are higher. The higher the level of anxiety and depression, the lower the quality of life.
The results of this study showed that The total SSRS score of kidney transplant recipients was (39.57±7.99), which was higher than that of the domestic norm [19]. model [19]. The total SSRS score was positively correlated with the scores of all dimensions except the social functioning dimension (P<0.05). positive correlation (P<0.05). Kidney transplant recipients received the most support from their spouses, parents and siblings. family members such as spouse, parents and siblings, while colleagues and neighbors also cared and helped them. The better the social support, the better the quality of life.
In conclusion, good social support can improve patients' ability to cope with negative emotions [20]. The better the social support, the better the quality of life. In conclusion, good social support can improve patients' ability to cope with negative emotions [20]. As medical professionals, in addition to making patients perceive intra-family support, there is more In addition to internal family support, there are more external support resources available to provide In addition to internal family support, there are more external support resources available for patients to provide information support, such as the formation of a renal transplantation micro-letter group with specialist nurses to answer patients' questions. We can provide information and support to patients, such as forming a kidney transplant micro-letter group, having a medical specialist on hand to answer patients' questions, intervening in negative emotions, and encouraging We can also encourage and guide kidney transplant recipients to make full use of social support networks and adopt positive coping strategies to promote their physical and mental health. To encourage and guide kidney transplant recipients to make full use of their social support network and adopt positive ways of coping to promote their physical and mental health and thus improve their quality of life.
