Mode and effect of cognitive-behavioral therapy for liver transplant recipients waiting for a liver transplant

doi:10.3969/j.issn.2095-4344.2014.05.006

Abstract

Abstract:

BACKGROUND: With the development and improvement of liver transplantation technology, patients waiting for or undergoing liver transplantation have continued to increase in number. Due to their fears and concerns about post-transplantation rehabilitation, patients are under physical and mental stress, most of whom are shown to have a variety of mental disorders that affect rehabilitation. At present, mental problems of liver transplant patients are more concentrated in post-transplantation research, while patients waiting for liver transplantation do not get enough mental assessment and intervention.

OBJECTIVE: To investigate the suitable mode of cognitive-behavioral therapy for liver transplant recipients waiting for donor liver and to evaluate the effect to improve patient’s physical and mental state.

METHODS: Twelve liver transplant patients who underwent pre-transplantation assessment were randomly divided into experimental group and control group, each group with six cases. The control group received conventional treatment. The experimental group received cognitive-behavioral therapy in addition to conventional treatment. Self-rating anxiety scale (SAS) and vital signs were measured in the two groups on admission, 1 week and 3 weeks after admission.

RESULTS AND CONCLUSION: The SAS score of the experimental group was lower than that of the control group at 1 and 3 weeks after admission, and SAS score decreased as the intervention extended. The systolic blood pressure of the experimental group was lower than that of the control group at 3 weeks after admission, but there was no significant difference in diastolic blood pressure between two groups. The heart rate of the experimental group was lower than that of the control group at 1 and 3 weeks after admission. The respiratory rate of the experimental group was lower than that of the control group at 3 weeks after admission. Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness in patients waiting for liver transplantation.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: liver transplantation, cognitive therapy, anxiety, blood pressure, heart rate

CLC Number:

R318

Su Jing-han, Wang Shu-yan, Liang Xue, Zhu Mei-ling, Qiao Shan, Yin Hong-ying. Mode and effect of cognitive-behavioral therapy for liver transplant recipients waiting for a liver transplant[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(5): 687-692.

Figures/Tables 1

References

[1] 童玲.心理护理干预对老年手术患者心理影响研究[J].中国现代医生,2010,48(36):58,68.

[2] 丁文涛.结合国情努力提高我国肝移植水平[J].中国器官移植杂志,2001,22(3):132.

[3] 廖苑,伍梅娟,潘雄英,等.肝移植受者手术前后焦虑状况及其影响因素分析[J].现代临床护理,2012,11(10):1-4.

[4] 王丽,罗艳丽.肝移植受者焦虑与社会支持的相关性研究[J].护理学报,2012,19(4):74-75.

[5] 邢文婷,陈琪尔,谭坚玲,等.肝移植受者焦虑状况及其影响因素的研究[J].护理研究,2010,24(31):2835-2838.

[6] 刘江伟,张永久,雷涛, 等.肝移植患者的焦虑、抑郁状态评估[J].中国临床康复,2006,10(38):17-19.

[7] 陈规划,汪根树,陆敏强, 等.肝移植术后受者焦虑状况调查及病因探讨[J].中华消化外科杂志,2007,6(1):19-21.

[8] Barbour KA,Blumenthal JA,Palmer SM.Psychosocial issues in the assessment management of patients undergoing lung transplantation.Chest. 2006;129(5):1367-1374.

[9] Vermeulen KM,Bosma OH,Bij W,et al.Stress,psychological distress,and coping in patients on the waiting list for lung transplantation:an exploratory study.Transpl Int. 2005; 18(8): 954-959.

[10] 丁淑芬,鲁萍.住院肝硬化患者抑郁情绪及相关因素的调查分析[J].现代护理,2007,13(10):945-946.

[11] 范蓉,高振明,王立明.肝移植患者抑郁情绪的临床研究[J].中国医学工程,2007,15(1):40-41.

[12] 陈琪尔,汪根树,黄俭强.肝移植受者抑郁状况调查分析及对策[J].护理学杂志,2009,24(12):89-91.

[13] 殷朝华.健康教育对肾移植术后患者情绪情感及生活质量影响的临床观察[J].中国实用护理杂志,2011,27(8):49-50.

[14] Napolitano MA, Babyak MA, Palmer S,et al.Effects of a telephone-based psychosocial intervention for patients awaiting lung transplantation.Chest. 2002;122(4):1176-1184.

[15] 张玲,潘润德,陈强,等.认知行为和抗焦虑药治疗焦虑障碍的随机对照研究[J].中国神经精神疾病杂志, 2007, 33(12): 755-760.

[16] DuHamel KN,Mosher CE,Winkel G, et al. Randomized clinical trial of telephone- administered cognitive- behavioral therapy to reduce post -traumatic stress disorder and distress symptoms after hematopoietic stem -cell transplantation.J Clin Oncol. 2010; 28(23): 3754-3761.

[17] van Weert E,May AM,Korstjens I, et al.Cancer – related fatigue and rehabilitation:a randomized controlled multicenter trial comparing physical training combined with cognitive – behavioral therapy with physical training only and with no intervention.Phys ther. 2010;90(10):1413-1425.

[18] Crandall M, Lammers C, Senders C,et al.Initial validation of a numeric zero to ten scale to measure children's state anxiety. Anesth Analg. 2007;105(5):1250-1253.

[19] 郭晓娟,张运生,杨卫芹,等.认知行为干预在住院冠心病患者护理中的应用[J].河南大学学报:医学版, 2010, 29(2): 128-132.

[20] 黄慧兰,刘新民.团体人际心理干预与团体认知行为干预对社交焦虑的疗效[J].中国心理卫生杂志,2011,25(5): 324-327.

[21] Fusar-Poli P,Lazzaretti M,Ceruti M,et al.Depression after lungtransplantation:causes and treatment. Lung.2007; 185(2):55-65.

[22] MeKiernan A. A controlled trial of group cognitive behavior therapy for Irish breast cancer patients. J Psychosoc Oncol. 2010;28(2):143-156.

[23] Kapella MC,Herdegen JJ, Perlis ML, et al.Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects.Int J Chron Obstruct Pulmon Dis. 2011;24(6): 625-635.

[24] 苏海丹,黄春燕,成翠真,等.对老年患者防跌倒的认知行为干预[J].中国实用护理杂志,2006,22(2):6-7.

[25] 毛敏.认知行为干预与白血病患者负性情绪的相关性研究[J].中国实用护理杂志,2011,27(7):20-22.

[26] 郝玉静,赵立华,郝志敏,等.认知行为干预对直肠癌术后放疗患者心理及生活质量的作用[J].重庆医学,2011,40(7): 723-724.

[27] 李静娣,陈桂凤,张静,等.认知行为干预对高中生慢性乙型肝炎病毒携带者负性情绪的影响[J].中华现代护理杂志,2010,16(11): 1277-1278.

[28] 林细吟,覃惠英,尤黎明,等.宣泄和认知行为干预对乳腺癌术后化疗患者生活质量的影响[J].现代临床护理,2010,9(1):1-3.

[29] 龙瑞芳,李连启.认知行为疗法在心理护理工作中的应用(附100例住院精神分裂症对照分析) [J].山东精神医学,2001,14(4): 261-263.

[30] Charles Given,Barbara Given,Mohammad Rahbar,et al. Effect of a cognitive behavioral intervention on reducing symptom severity during chemotherapy.J Clin Oncol. 2004;22(3):507-516.

[31] 林凤仙.认知心理干预对老年冠心病患者遵医行为和临床疗效的影响[J].中国全科医学,2007,10(19):1614-1614.

[32] 刘艳.认知行为干预对心力衰竭患者负性自我概念及生活质量的影响[J].中国实用护理杂志,2010,26(34):14-16.

[33] 许小青,李连君.认知行为干预对乳腺癌手术病人负性自我概念影响的研究[J].护理研究,2010,24(8):692-693.

[34] 陈咏梅,王卫敏,鲍文卿,等.结构化认知行为干预对精神分裂症患者生活质量的影响[J].中国实用护理杂志,2010,26(8): 61-62.

[35] Given C, Given B, Rahbar M,et al.Effect of a cognitive behavioral intervention on reducing symptom severity during chemotherapy.J Clin Oncol. 2004;22(3):507-516.

[36] Najafizadeh K,Ghorbani F,Rostami A,et al.Health status of the patients before lung transplantation:a report from Iran.Ann Transplant. 2009;14(1):5-9.

[37] Vandemheen KL,O'Connor A,Bell SC,et al. Randomized trial of a decision aid for patients with cystic fibrosis considering lung transplantation.Am J Respir Crit Care Med. 2009;180(8): 761-768.

[38] 李美娟,邬德纯,李凤香.认知行为心理干预对慢性精神分裂症康复的影响[J].现代临床护理,2007,6(1):10-11.

[39] 谢忠,银正民,黄钢,等.认知行为干预疗法对癌症患者抑郁症的对照研究[J].健康心理学杂志,2001,9(4):302-305.

[40] 汪向东,王希林,马弘.心理卫生评定量表手册[M].增订版.北京:中国卫生杂志社,1999:235-238,194,196.

[41] 周卓林.认知行为干预对急性冠状动脉综合征患者心理状态的影响[J].护理学杂志,2006,21(15):56-57.

[42] 吴庆珠.认知行为干预对剖宫产产妇焦虑、抑郁情绪的影响[J].护士进修杂志,2011,26(15):1422-1423.

[43] 孙世波.瑞典肝移植简介[J].中华肝胆外科杂志,2003,9(5):295.

[44] 王建荣,郭俊艳,马艳兰.音乐放松想象训练对腹腔镜肝切除患者术后恢复的影响[J].中华护理杂志,2006,41(4):293-296.

[45] 姚桂英.护士抑郁情绪的影响因素与调适策略[J].中国社区医师(医学专业),2010,12(20):270.

[46] 吴雪,冯美丽,娄凤兰,等.认知行为干预对维持性血液透析患者生活质量的影响[J].中国护理杂志,2006,41(8):715-717.

[47] Bally K,Campbell D,Cheanick K,et al.Effects of patient-controlled music therapy during cornary angiography on procedural pain and anxiety distress syndrome.Crit Care Nurs.2003;23(1):50-57.

[48] 李晓丹.认知行为干预对经皮冠脉介入治疗患者应激反应的影响[D].郑州:郑州大学,2011.

[49] 王建平,林文娟,陈仲庚,等.简明心境量表(POMS)在中国的试用报告[J].心理学报,2000,32(1):110-114.

[50] Najafizadeh K,Ghorbani F,Rostami A,et al.Depression while on the lung transplantation waiting list.Ann Transplant. 2009; 14(2):34-37.

[51] 朱玉花,丁英,邵东平,等.护理干预对糖尿病患者术前焦虑和血糖的影响[J].中国实用护理杂志,2006,22(20):14-15.

[52] Claas Lahmann,Rainer Schoen,Peter Henningsen,et al.Brief relaxation versus music distraction in the treatment of dental anxiety.J Am Dent Assoc. 2008;139(3):317-324.

[53] 蔡光蓉,乔宜.音乐疗法在肿瘤临床应用的探讨[J].医学与哲学, 1994,15(2):41-42.

[54] Marwick C.Leaving concert hall for clinic,therapists now test music's charms.JAMA.1996;275:267-268.

[55] Lahmann C, Schoen R, Henningsen P,et al.Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial.J Am Dent Assoc. 2008; 139(3):317-324.

[56] Blumenthal JA,Babyak MA,Keefe FJ,et al.Telephone-based coping skills training for patients awaiting lung transplantation. J Consult Clin Psychol. 2006;74(3):535-544.