We studied 10 boys, and 15 girls, all below the age of 16, who had been referred to the National Hospital in Norway for evaluation for transplantation of either the heart, or the heart and lungs. These represent the complete cohort of patients being considered for transplantation between 1990 and 1997. Of the 25 children and their families, 24 sets underwent a comprehensive psychosocial assessment, including interviews with both parents and their children. The parents completed the Child Behavior Checklist and the General Health Questionnaire. We had accepted 15 children for transplantation and placed them on the waiting list. The others were rejected for medical reasons, and 3 died whilst waiting for an organ. One was reconsidered for conventional surgery and removed from the list. Transplantation was performed in 11 children, whilst one of the patients we had rejected underwent transplantation abroad, and was included in the study. This left 12 patients in the final sample, with a mean age of 8 years, and with a range from 11 months to 13.9 years. We reassessed their psychosocial and physical functioning two years after transplantation. Of those undergoing transplantation of the heart and lungs, two were severely affected by progressive obliterative bronchiolitis. The others were in good general physical condition. At the assessment prior to transplantation, three already fulfilled the criterions for diagnosis of an overanxious disorder. Two others had symptoms of anxiety and depression, but without fulfilling the accepted criterions. At follow- up, two patients retained this psychiatric diagnosis. Increased levels of stress were uncovered in the parents prior to surgery, but these had normalised at follow-up. The study shows that, in general, physical and psychological conditions improve in children undergoing transplantation, but they and their parents live in a stressful environment, and are in need of psychosocial support both before and after transplantation.

译文

我们研究了10个男孩和15个女孩,年龄都在16岁以下,他们被转诊到挪威国家医院进行心脏或心脏和肺部移植的评估。这些代表正在考虑进行移植1990年和1997的患者的完整队列。在25名儿童及其家庭中,有24套接受了全面的社会心理评估,包括对父母及其子女的访谈。父母完成了儿童行为清单和一般健康问卷。我们接受了15名儿童进行移植,并将他们列入了等待名单。其他人因医疗原因被拒绝,其中3人在等待器官时死亡。其中一个被重新考虑进行常规手术,并从列表中删除。在11名儿童中进行了移植,而我们拒绝的其中一名患者在国外进行了移植,并被纳入了研究。最终样本中剩下12名患者,平均年龄为8岁,范围为11个月至13.9岁。移植后两年,我们重新评估了他们的心理和身体功能。在接受心脏和肺部移植的患者中,有两例受到进行性闭塞性细支气管炎的严重影响。其他人的身体状况良好。在移植前的评估中,三个已经满足了过度焦虑障碍的诊断标准。另外两个人有焦虑和抑郁的症状,但没有达到公认的标准。在随访中,两名患者保留了这种精神病诊断。手术前父母发现压力水平增加,但随访时压力已恢复正常。研究表明,总体而言,接受移植的儿童的身体和心理状况有所改善,但他们及其父母生活在压力大的环境中,并且在移植前后都需要社会心理支持。

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