Psychological Investigation Of Cardiac Transplantation Recipients

Objective: To investigate and to evaluate the mental health of orthotopic heart transplantation recipients,in order to find the psychological problems. Furthermore,taking corresponding measures on psychological problems and psychological intervention to enhance the coping capacity of patients.Results: Studies have shown that heart transplant recipients had psychological problems with somatization, anxiety, depression, hostility, phobic. Before the intervention, it was found that the self-rating anxiety scale standard score, forward questions average score and reverse questions average score of the heart transplantation are higher than the norms, the differences were statistically significant (P <0.05). Patients in the SDS self-rating depression scale in the standard score, coarse score were higher than the norms,the differences were statistically significant (P <0.05).Such factors as Somatization,depression,anxiety,hostility,phobia, and total average scores of SCL-90 in patients were significantly higher than the norms (P<0.05). Social Support rating Scale in patients with objective support, subjective support, the level of using social support and total score were lower than the norms, the differences were statistically significant (P <0.05). Univariate analysis showed that the general factors in patients with gender, age, educational level, rehabilitation knowledge, per capita monthly income, whether had a job,health insurance, postoperative complications, postoperative survival time impacted on the patients' psychological problems at different levels and different aspects. Correlation analysis showed that SAS standard scores,SDS standard scores and somatization, anxiety, depression, hostility, phobic, total average scores of SCL-90 were negatively related to the most dimensions of SSRS(r =- 0.339 ~ -0.706, P <0.05). Active coping style was negatively related to SAS standard scores, SDS standard scores ,SCL-90 in patients with somatization, anxiety, depression, hostility, phobic and total average scores (P <0.05, r =- 0.750 ~ -0.258), negative coping style on the contrary(P<0.05,r=0.283~0.744). Multiple linear stepwise regression analysis also confirmed the patient's demographic factors, the dimensions of social support, coping style have relation with psychological problems.The further survey on the patients' psychological status, social support and personal coping style was carried out 1 month later after appropriate measures and Psychological intervention given to patients.The results showed that patients after intervention in SAS standard scores, forward questions average score and reverse questions average score were still higher than the norms but lower than before intervention, differences were statistically significant (P <0.05,P<0.05). SDS survey showed similar results,patients took higher scores than the norms but lower than before intervention. SCL-90 scale after the intervention in the scores of somatization, depression, anxiety and total average scores higher than the norms, the differences were statistically significant (P<0.05); otherwise hostility and phobia ,compared with the norms, the difference were not statistically significant (P> 0.05). There were significant differences in somatization,depression,anxiety,hostility and phobia between two groups before and after intervention, the group after intervention took the lower score(P<0.05). After intervention,various dimensions of SSRS were still lower than normal group, the differences were statistically significant (P <0.05). The comparison of patients before and after intervention,social support total scale, subjective support, the support application dimension increased to varying degrees after intervention, the differences were statistically significant (P <0.05);but the objective support score was not statistically significant (P> 0.05). Active coping style took higher score after intervention,and negative coping style on the contrary,the results had statistical significance (P <0.05,P<0.05).Conclusion: Heart transplantation patients had psychological problems, mainly in the somatization, anxiety, depression, hostility, phobic.The demographic differences and the general factors ,such as gender, age, educational level, rehabilitation knowledge, per capita monthly income, whether had a job,health insurance, postoperative complications, postoperative survival time impacted on the psychological problems of patients at different levels and different aspects. Also the severity of psychological problems in patients had some relevance with social support and personal coping styles.The influencing factors on psychological problems which could be intervented were whether had a job, economic conditions, complications, adverse drug reaction, rehabilitation knowledge deficit, social support, personal coping style, etc. After appropriate measures and Psychological intervention given, patients' social support scores and active coping styles scores had been improve,also the Mental Health Level. Therefore, the medical staff and government should pay more attention and take more effective actions to improve heart transplantation recipient s' mental health.