심장이식 수혜자의 삶의 질 관련 요인에 대한 메타분석
A Meta-Analysis on Factors Related to Quality of Life in Heart Transplant Recipients
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목적 : 본 연구는 심장이식 수혜자의 삶의 질 관련 요인을 탐색하기 위한 체계적인 문헌고찰 및 메타분석이다. 방법 : 심장이식 수혜자의 삶의 질 관련 요인을 제시하는 연구를 확인하기 위해 6개의 데이터베이스(PubMed, CINAHL, EMBASE, Cochrane, KMBASE, RISS)를 이용하여 1974년부터 2018년 11월까지 출판된 논문을 검색하였다. PRISMA 그룹에서 제시하는 문헌검색 흐름도에 따라 체계적인 고찰과 메타분석을 위해 총 5,234개의 연구 중 22개의 연구가 선정되었다. 연구의 질 평가는 NIH의 평가 도구를 이용하여 평가하였고, 메타분석은 'R 3.5.2' 버전을 사용하여 상관관계 효과크기를 분석하였다. 결과 : 심장이식 수혜자의 삶의 질 관련 요인은 Ferrans의 건강 관련 삶의 질 모델에 근거하여 6가지 영역(개인, 환경, 생물학적 기능, 증상, 기능상태 및 일반적인 건강 인식)으로 범주화하였다. 메타분석에는 34개의 요인이 사용되었고, 분석을 통해 유의한 상관관계 효과크기를 갖는 17개의 요인은 다음과 같다: 개인적 특성 영역(자기 효능, demoralization, 지각된 통제력, 현재 직업 유무, 연령, 결혼 상태, 건강증진 삶의 방식), 환경적 특성(스트레스), 생물학적 기능(신체 기능상태, 크레아티닌 수준, 좌심실 구혈율), 증상 영역(불안, 우울증, 증상 빈도 및 증상 고통감), 기능상태 영역(대처, 자가간호 이행). 결론 : 본 연구의 결과는 심장이식 수혜자의 삶의 질에 영향을 미치는 다차원적 요소를 제시하고 심장이식 수혜자의 삶의 질 향상을 위한 효과적인 중재를 개발하기 위한 증거를 제공한다.
Abstract
Purpose: This study was a systematic review and meta-analysis to explore the factors related to quality of life in heart transplant recipients. Methods: To identify studies that suggested the factors related to the quality of life in heart transplant recipients, we searched the articles published from 1974 to November 2018 using Six databases, PubMed, CINAHL, EMBASE, Cochrane, KMBASE and RISS. A total of 22 studies were selected out of 5,234 for the systematic review and meta-analysis on the basis of the PRISMA flow. The quality of study was assessed by assessment tool form the NIH and meta-analysis was performed using the ‘R 3.5.2’ version to analyze the correlated effect sizes. Results: Factors related to quality of life in heart transplant recipients were categorized into six domains based on the health-related quality of life model introduced by Ferrans: individual, environmental, biological function, symptoms, functional status, and general health perception. In the meta-analysis, 34 factors were used and 17 factors having significant effect sizes were as follows: self-efficacy, demoralization, perceived control, current occupational status, age, marital status, health promotion life style in the individual characteristics; stress in environmental characteristics; physical function status, creatinine level, left ventricular ejection fraction (LVEF) in biological function; anxiety, depression, symptom frequency and distress in symptoms domain; coping, self-care compliance in functional status. Conclusion: The findings indicate that the multi-dimensional factors influencing the quality of life in heart transplant recipients and provide the evidence for developing effective interventions for improving the quality of life of recipients.
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