维持性血液透析患者衰弱的发生情况及其影响因素分析

    Analysis of the incidence and influencing factors of frailty in maintenance hemodialysis patients

    • 摘要: 目的 调查维持性血液透析患者衰弱现状,并分析其心理社会影响因素。方法 采取方便抽样法,选取2017年2月至2019年2月于南通大学附属南通中医院接受维持性血液透析治疗的180例患者纳入研究。通过查阅病历和实验室检验记录收集患者临床资料,采用衰弱量表、匹兹堡睡眠质量指数、医院焦虑和抑郁量表、心理弹性量表、慢性疾病自我效能量表和领悟社会支持量表评估患者衰弱状况、睡眠质量、焦虑抑郁、心理弹性、自我效能感和社会支持。根据衰弱得分将患者分为非衰弱组、衰弱前期组和衰弱组。比较各组患者临床资料和心理社会因素评分的差异,并采用Logistic回归分析探索衰弱影响因素。结果 回收176份有效问卷,176例患者中,11例(6.3%)发生衰弱。Logistic回归分析显示,年龄、合并症、抑郁和睡眠障碍是维持性血液透析患者发生衰弱的危险因素,心理弹性和社会支持是维持性血液透析患者发生衰弱的保护因素(P<0.05)。结论 护理人员应早期评估患者衰弱状况和健康状况,采取针对性护理策略,延缓合并症进展,改善睡眠质量,控制抑郁症症状,促进患者心理健康和社会支持,从而改善衰弱。

       

      Abstract: Objective To explore the current status of debilitating patients on maintenance hemodialysis and analyze their psychosocial factors.Methods A convenient sampling method was adopted for 180 patients on maintenance hemodialysis from February 2017 to February 2019.Medical records and laboratory tests were reviewed for collecting general and clinical data.Deterioration Scale,Pittsburgh Sleep Quality Index,Hospital Anxiety & Depression Scale,Psychological Resilience Scale,Chronic Disease Self-Efficacy Scale and Perceived Social Support Scale were employed for evaluating patient debilitating condition,sleep quality,anxiety & depression,psychological resilience,self-efficacy and social support.Logistic regression analysis was performed for variables with statistical differences in univariate analysis.Results A total of 176 valid questionnaires were recovered and 11/176 patients(6.3%) suffered from debilitation.Logistic regression analysis indicated that the influencing factors were age,comorbidities,depression,sleep disorders,psychological resilience and social support(P<0.05).Conclusion s Age,comorbidities,depression and sleep disorders are risk factors for frailty and psychological resilience and social support is a protective factor for frailty.Nursing staff should evaluate patient frailty and health status early,adopt targeted nursing strategies,delay the progression of comorbidities,improve sleep quality,control depression symptoms,promote mental health and promote social support.

       

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