慢性肾脏病3~5期非透析患者恐惧疾病进展与生活质量的相关性研究

    Correlation between fear of disease progression and quality-of-life in non-dialysis patients with chronic kidney disease in stages 3-5

    • 摘要:
      目的  评估影响慢性肾脏病(chronic kidney disease,CKD)3~5期非透析患者恐惧疾病进展的因素,探讨其对生活质量的影响。
      方法  采用疾病进展恐惧简化量表(fear of progression questionnaire-short form,FoP-Q-SF)和健康调查简表(the Mos 36-item short form health survey,SF-36)对2022年6月至2023年5月安徽医科大学第二附属医院肾脏内科就诊的CKD 3~5期非透析患者进行恐惧疾病进展程度和生活质量相关问卷调查。收集一般人口学资料及临床相关指标,分析疾病进展恐惧程度及影响因素,与生活质量的相关性。
      结果  纳入130例CKD 3~5期非透析患者,恐惧疾病进展得分(32.84 ± 6.13)分,43.84%的患者达到严重的心理功能失调标准(≥34分)。多元线性回归分析结果显示,年龄(t = −2.024)、文化程度(t = −2.690)、情绪状态(t = 6.808)、疾病分期(t = 2.134)及钙磷代谢水平(t = −2.099)是患者FoP得分的影响因素(P<0.05)。非透析CKD患者生活质量评分均低于中国常模评分。存在心理功能失调的患者SF-36量表各维度评分明显低于不存在心理功能失调患者,差异有统计学意义(P<0.05)。非透析CKD患者的恐惧疾病进展评分与生活质量评分呈负相关(P<0.05)。
      结论  非透析CKD患者恐惧疾病进展严重影响其生活质量,恐惧疾病进展程度与年龄、文化程度、情绪状态、疾病分期及存在钙磷代谢异常相关,需要医护人员进一步重视健康教育及社会支持等。

       

      Abstract:
      Objective  To evaluate the influencing factors of fear of disease progression and examine its impact on quality-of-life in non-dialysis patients with chronic kidney disease (CKD) in stages 3-5.
      Methods  From June 2022 to May 2023, 130 non-dialysis CKD patients in stages 3-5 were examined by Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and Mos 36-item short-form health survey (SF-36). General demographics and clinical related parameters were recorded. Degree of FoP, its influencing factors and correlation with quality-of-life were explored.
      Results  Average score of FoP-Q-SF was (32.84 ± 6.13) and 43.84% of them fulfilled the dysfunctional fear of progression criterion (score≥34). Multiple stepwise linear regression analysis indicated that age (t = −2.024), education level (t = −2.690), emotional state (t = 6.808), disease stage (t = 2.134) and abnormal calcium & phosphorus metabolism (t = −2.099) were the influencing factors for fear of disease progression (P<0.05). Quality-of-life scores of CKD patients were lower than those of Chinese normative scores and quality-of-life was lower. In patients with FoP-Q-SF score equal or greater than 34 points, scores of each dimension of SF-36 scale were significantly lower than those with FoP-Q-SF score <34 points (P<0.05). A significant negative correlation existed between FoP and quality-of-life in non-dialysis CKD patients in stages 3-5.
      Conclusion  In patients with non-dialysis CKD, fear of disease progression seriously affects their quality-of-life. It is correlated with age, education level, emotional state, disease stage and abnormal calcium & phosphorus metabolism. Physicians should devote greater efforts to health education and social supports.

       

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