活体肝脏捐献者生命质量影响因素的系统综述  

A systematic review of the factors significantly influencing the quality of life of living liver donors

作　　者：施月仙 张海明 朱志军 Yuexian Shi;Haiming Zhang;Zhijun Zhu(School of Nursing,Peking University,Beijing,China;Liver Transplantation Center,National Clinical Research Center for Digestive Diseases,Clinical Center for Pediatric Liver Transplantation,Beijing Friendship Hospital,Capital Medical University,Beijing,China)

机构地区：[1]School of Nursing,Peking University,Beijing,China [2]Liver Transplantation Center,National Clinical Research Center for Digestive Diseases,Clinical Center for Pediatric Liver Transplantation,Beijing Friendship Hospital,Capital Medical University,Beijing,China

出　　处：《International Journal of Nursing Sciences》2023年第4期579-586,I0006,共9页国际护理科学（英文）

基　　金：supported by National Natural Science Foundation of China(grant number 71974008).

摘　　要：目的旨在对活体肝脏捐献者捐献后生命质量的影响因素进行梳理和归纳,为临床护理制订有针对性的干预措施提供参考依据。方法对PubMed、EMBASE、CINHAL、Web of Science和ProQuest数据库进行检索。检索时间为建库至2022年6月,纳入经过同行评审的英文文献,包括对捐献后活体肝脏捐献者生命质量影响因素进行分析的横断面研究或纵向研究。采用美国国立卫生研究院横断面研究和纵向研究质量评估工具(修订版)对纳入研究的方法学质量进行评价。结果共检索出6576篇文献,16篇符合纳入标准。将文献中影响活体肝脏捐献者生命质量的相关因素归纳为4类:社会人口学因素(性别、年龄、受教育程度、民族和婚姻状况)、捐献肝脏相关因素(捐献相关的住院时间或住院次数、受者结局、捐献后时长、捐献后并发症、捐献决定受支持情况、术前对个人健康担忧、捐献前存在捐献的矛盾心理、与受者关系)、健康状况相关因素(体质指数和捐献前有躯体症状)和心理社会因素(捐献前躯体和心理状态评分、家庭收入、焦虑、抑郁)。多数研究报道,老年、受者死亡、捐献肝脏后近期、捐献者经历术后并发症以及捐献者对自身健康的担忧是躯体功能的负面影响因素。女性捐献者、低教育水平、因捐献而住院时间长和/或住院次数多、受者预后不佳、捐献后近期、捐献肝脏前对自身健康担忧以及一级亲属和配偶捐献者是捐献后不良心理状态的负面预测因素。纳入研究中,仅有2篇文献考虑了社会功能的影响因素。结论活体肝脏捐献者的生命质量不仅受到捐献手术的影响,还包括心理和社会方面的因素。临床护理工作者可根据上述影响因素为捐献者制订有针对性的护理措施,以提高肝脏捐献者的生命质量。Objectives:This systematic review aimed to synthesize the literature on factors influencing the quality of life in living liver donors post-donation and to provide a reference for developing targeted interventions in clinical practice.Methods:A systematic search guided by the PRISMA 2020 approach was performed on specific databases:PubMed,EMBASE,CINHAL with full text,Web of Science,and ProQuest Dissertations&Theses databases.Peer-reviewed articles published in English from inception to October 2022 covering crosssectional studies and longitudinal studies on factors affecting the quality of life of living liver donors after donation were included in this systematic review.The methodological quality of the studies was examined using a modified version of the National Institutes of Health Quality Assessment Tool.Results:A total of 6,576 studies were retrieved,and 16 eligible studies were finally included.Four types of independent influencing factors:sociodemographic(gender,donor age,education,ethnicity,and marital status),donation-related(length of hospital stay and number of hospitalizations/hospital visits related to donation surgery,recipient outcome,time from donation,complications,donation decision,ambivalence about donating,donor-recipient relationship),health-related(body mass index and predonation physical symptoms),and psychosocial(pre-donation physical and mental score,household income,anxiety,depression),were extracted from the included studies.Several studies consistently identified old age,recipient death,recent donation,postoperative complications experienced by donors,and donor concerns about their well-being as negative influencing factors on physical function.Female donors,low education levels,longer hospital stays,and/or more hospital visits due to donation,poor recipient outcome,recent donation,pre-donation concerns regarding their well-being,and first-degree relative and spouse/partner donors were reported in several studies as negative predictors for psychological status.Factors affecting social

关 键 词：活体捐献者 肝移植 心理社会功能 生命质量 系统综述 

分 类 号：R47[医药卫生—护理学]