بررسی ارتباط تبعیت از درمان با افسردگی، اضطراب و راهبردهای مقابله‌ای در بیماران پیوند کلیه

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، مرکز تحقیقات علوم رفتاری و گروه روان‌پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، مرکز تحقیقات روان‌تنی و گروه روان‌پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشجوی پزشکی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استادیار، مرکز تحقیقات روان‌تنی و گروه روان‌پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 دانشیار، مرکز تحقیقات بیماری‌های کلیه و گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: یکی از عوامل مؤثر در ماندگاری کلیه‌ی پیوند شده، تبعیت کامل بیمار از دستورهای دارویی است، اما برخی پژوهش‌ها نشان داده است که بعضی بیماران، به علل مختلف از جمله علل روان‌شناختی، پیروی کامل از دستورهای دارویی ندارند. مطالعه‌ی حاضر با هدف تعیین ارتباط بین تبعیت از درمان در بیماران تحت پیوند کلیه با عوامل روان‌شناختی شامل افسردگی، اضطراب و راهبرد‌های مقابله‌ای آنان به انجام رسید.روش‌ها: طی یک مطالعه‌ی مقطعی در سال 1394 در مراکز آموزشی- درمانی الزهرا (س) و نور و حضرت علی‌اصغر (ع) شهر اصفهان، 85 بیمار تحت پیوند کلیه از نظر ارتباط بین تابعیت از درمان و عوامل روان‌شناختی از جمله افسردگی، اضطراب و راهبرد‌های مقابله‌ای با استفاده از پرسش‌نامه‌های اضطراب و افسردگی بیمارستان (Hospital Anxiety and Depression Scale یا HADS)، راهبرد‌های مقابله‌ای (Brief coping strategy questionnaire یا Brief COPE) و پرسش‌نامه‌ی ساده شده‌ی تبعیت از درمان (Simplified medication adherence questionnaire یا SMAQ) مورد بررسی قرار گرفتند.یافته‌ها: 43 بیمار (6/50 درصد) دارای همکاری و 42 بیمار (4/49 درصد) فاقد همکاری (چسبندگی به درمان) بودند. میانگین نمره‌ی اضطراب در بیماران با و بدون همکاری اختلاف معنی‌داری بین دو گروه نشان نداد (210/0 = P)، اما میانگین نمره‌ی افسردگی در بیمارانی که عدم همکاری داشتند، به ‌طور معنی‌داری بالاتر بود (043/0 = P). میانگین نمره‌ی خرده آزمون مذهب از آزمون مقابله با استرس، در گروه دارای همکاری به ‌طور معنی‌داری بالاتر بود (039/0 = P).نتیجه‌گیری: میزان تبعیت بیمار از درمان در بیماران تحت کلیه‌ی پیوندی، به میزان زیادی به شدت افسردگی بستگی دارد و توجه و تمرکز بیشتر بر روی درمان افسردگی ضروری به نظر می‌رسد.

کلیدواژه‌ها

عنوان مقاله [English]

The Relationship of Drug Compliance with Depression, Anxiety and Coping Strategies in Patients with Kidney Transplantation

نویسندگان [English]

  • Victoria Omranifard 1
  • Amrollah Ebrahimi 2
  • Taysir Basti 3
  • Mohammad Reza Sharbafchi 4
  • Shahram Sajjadieh 5
  • Mojgan Mortazavi 5
1 Associate Professor, Behavioral Sciences Research Center AND Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Psychosomatic Research Center AND Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Psychosomatic Research Center AND Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
5 Associate Professor, Kidney Disease Research Center AND Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: One of the influent factors in successful kidney transplantation is complete drug compliance in patients; but some of the studies had shown that some patients are not fully compliant because of several reasons including psychological factors. This study aimed to assess the relationship of the drug compliance in patient with kidney transplantation with psychological factors including depression, anxiety and coping strategies.Methods: In a cross-sectional study during 2015-2016 in Alzahra and Noor and Aliasghar Hospitals in Isfahan, Iran, 85 patients with kidney transplantation were assessed in terms of relationship of drug compliance with psychological factors such as depression, anxiety and coping strategies using Hospital Anxiety and Depression Scale (HADS), Brief COPE (coping strategy) inventory and the simplified medication adherence questionnaire (SMAQ).Findings: In this study, 43 patients (50.6%) were compliant and 42 patients (49.4%) were noncompliant. The mean score of anxiety showed no significant difference between the two groups (P = 0.210), but the mean score of depression was significantly higher in noncompliant group (P = 0.043). The mean score of religious sub scale of coping strategies was higher in compliant group significantly (P = 0.039).Conclusion: According to this study, drug compliance in patients with kidney transplantation is related to depression significantly and diagnosis and treatment of depression is very important in these patients.

کلیدواژه‌ها [English]

  • Patient Compliance
  • Anxiety
  • Depression
  • Coping skills
  • Kidney transplantation

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مجله دانشکده پزشکی اصفهان
دوره 34، شماره 409 - شماره پیاپی 409
بهمن و اسفند 1395
صفحه 1430-1438

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سابقه مقاله

  • تاریخ دریافت: 31 شهریور 1395
  • تاریخ بازنگری: 05 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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