R. Santos Junior, M.C.O.S.Miyazakia, N.A.M. Domingos, N.I. Valério, R.F. Silva, R.C.M.A. Silva

背景：肝移植是治疗终末期肝病的方法之一，通过肝移植能够改善患者的社会康复能力及生活质量。本研究的目的是评价肝移植患者的社会心理学特征、抑郁症以及生活质量。

材料与方法：我们采用半引导式访问对患者进行个体评价，模式包括Back抑郁问卷和SF-36生活质量调查问卷。同时我们还运用了信号测试，水平定义在.05。

结果：样本的特性(n = 30)与文献资料中性别（20例男性）、年龄（平均51.96岁）、教育程度（小学或初中）、病因（病毒性肝炎）等特征均保持一致。在移植前（n = 18）或移植后（n = 13），有相当一部分患者由于免疫抑制剂的副作用（n = 9）而不能从事专业活动。分析表明，移植后患者在以下领域的生活质量得到了显著改善：履行职责的能力（P = .047）、身体状况（P = .024）、疼痛（P = .001）、整体健康状况（P = .003）和社会心理学状况（P = .021）等。移植前和移植后均有患者出现明显的抑郁症（n = 6）。

结论：研究数据表明，患者在肝移植之后生活质量得到了显著改善。职业活动和手术时间对手术结果有积极的影响。患者在移植前和移植后出现抑郁症的频率相似，这与较低的生活质量分数有一定的关系。研究结果表明，在不同治疗阶段均需要对患者定期提供心理评估和随访。

Patients Undergoing Liver Transplantation: Psychosocial Characteristics, Depressive Symptoms, and Quality of Life
R. Santos Junior, M.C.O.S.Miyazakia, N.A.M. Domingos, N.I. Valério, R.F. Silva, R.C.M.A. Silva

Background：Liver transplantation is the treatment of choice for patients with end-stage liver diseases to improve social rehabilitation and quality of life. Our objective was to evaluate the psychosocial characteristics, depressive symptoms, and quality of life among patients undergoing liver transplantation.

Materials and Methods：Patients underwent individual assessments using a semidirected interview. Beck's Depression Inventory and SF-36 Quality of Life Questionnaire. The signal test was used with a significance level set at .05.

Results：The characteristics of the sample (n = 30) were compatible with literature data for gender (n = 20 men), age (mean age, 51.96 years), education (elementary and middle school), and etiology (viral hepatitis). A significant number of patients were not able to maintain their professional activities: prior to transplantation (n = 18) and after transplantation (n = 13) due to the adverse effects of immunosuppressants (n = 9). The analysis indicated a significant quality of life improvement after transplantation for the following domains: functional capacity (P = .047), physical aspects (P = .024), pain (P = .001), overall health status (P = .003), and social aspects (P = .021). Significant depressive symptoms (n = 6) were experienced before and after the surgery.

Conclusions：The data indicated a significant quality of life improvement after liver transplantation. Occupational activity and surgery time had a positive influence on these results. The frequency of depressive symptoms was similar before and after transplantation, correlating with less favorable quality of life scores. The results indicated the need to provide regular psychosocial assessment and follow-up in all stages of therapy.

Volume 40, Issue 3, Pages 802-804 (April 2008)

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