中华护理杂志 ›› 2024, Vol. 59 ›› Issue (2): 156-163.DOI: 10.3761/j.issn.0254-1769.2024.02.004
曾豪洁(), 赵莉(), 张陈, 范艺禧, 罗文煜, 周金凤
收稿日期:
2023-06-02
出版日期:
2024-01-20
发布日期:
2024-01-15
通讯作者:
赵莉,E-mail:545667952@qq.com作者简介:
曾豪洁:女,硕士,护师,E-mail:136412402@qq.com
基金资助:
ZENG Haojie(), ZHAO Li(), ZHANG Chen, FAN Yixi, LUO Wenyu, ZHOU Jinfeng
Received:
2023-06-02
Online:
2024-01-20
Published:
2024-01-15
摘要:
目的 基于应激作用过程理论,构建维持性血液透析患者自我调节疲劳影响因素的结构方程模型,为制订缓解患者自我调节疲劳的干预方案提供参考。方法 2022年4月—11月采用一般资料调查表、自我调节疲劳量表、透析患者症状困扰量表、生活定向测验问卷修订版、领悟社会支持量表、简易疾病感知问卷和医学应对方式问卷对420例维持性血液透析患者进行问卷调查。结果 维持性血液透析患者自我调节疲劳得分为(49.52±10.93)分,自我调节疲劳与症状困扰、疾病感知、回避应对方式、屈服应对方式均呈显著正相关(r=0.476、0.428、0.303、0.611,均P<0.01);与领悟社会支持、气质性乐观均呈显著负相关(r=-0.410、-0.652,均P<0.01);与面对应对方式无显著相关性(r=-0.032,P>0.05)。Bootstrap分析显示,屈服应对方式、气质性乐观、领悟社会支持、疾病感知在症状困扰和自我调节疲劳间的中介效应显著(95%CI:0.027~0.203),症状困扰对自我调节疲劳的总效应为(P<0.001,95%CI:0.576~0.751),直接效应为(P<0.001,95%CI:0.170~0.357),间接效应为(P<0.001,95%CI:0.332~0.485),中介效应占总效应值的61.1%。结论 维持性血液透析患者自我调节疲劳程度较高,有待进一步改善。医护人员应及时评估和干预患者的症状困扰,重点引导患者调整心态,乐观看待疾病,为患者提供心理引导和压力应对策略,减少患者消极应对的行为倾向,引导患者正确感知社会关系中的支持与关怀,帮助患者树立正确的疾病认知,从而降低患者的自我调节疲劳。
曾豪洁, 赵莉, 张陈, 范艺禧, 罗文煜, 周金凤. 维持性血液透析患者自我调节疲劳的影响因素及路径分析[J]. 中华护理杂志, 2024, 59(2): 156-163.
ZENG Haojie, ZHAO Li, ZHANG Chen, FAN Yixi, LUO Wenyu, ZHOU Jinfeng. Analysis of influencing factors and pathway of self-regulatory fatigue in maintenance hemodialysis patients[J]. Chinese Journal of Nursing, 2024, 59(2): 156-163.
表1 调查对象的一般资料及不同人口学、疾病特征的维持性血液透析患者自我调节疲劳得分比较(n=420)
Table 1 Comparison of self-regulatory fatigue scores among MHD patients with different demographic and disease characteristics(n=420)
表2 维持性血液透析患者自我调节疲劳与症状困扰、疾病感知、气质性乐观、领悟社会支持、应对方式的相关分析结果(r值,n=420)
Table 2 Correlation analysis of self-regulatory fatigue, symptom distress, dispositional optimism, illness perception, perceived social support and coping style in MHD patients(r value,n=420)
[1] |
Engels N, de Graav GN, van der Nat P, et al. Shared decision-making in advanced kidney disease:a scoping review[J]. BMJ Open, 2022, 12(9):e055248.
DOI URL |
[2] |
Elgendy A, Abdelsalam AI, Mansour M, et al. Can residual kidney function affect quality of life and cognitive function in hemodialysis patients?[J]. BMC Nephrol, 2022, 23(1):263.
DOI PMID |
[3] |
秦静雯, 熊娟娟, 潘鑫, 等. 老年慢性心力衰竭患者运动恐惧现状及影响因素分析[J]. 中华护理杂志, 2022, 57(4):408-414.
DOI |
Qin JW, Xiong JJ, Pan X, et al. The status and influencing factors of kinesiophobia in elderly patients with chronic heart failure[J]. Chin J Nurs, 2022, 57(4):408-414.
DOI |
|
[4] | Nes LS, Ehlers SL, Whipple MO, et al. Self-regulatory fatigue in chronic multisymptom illnesses:scale development,fatigue,and self-control[J]. J Pain Res, 2013, 6:181-188. |
[5] |
Tao YX, Liu TC, Li P, et al. Self-management experiences of haemodialysis patients with self-regulatory fatigue:a phenomenological study[J]. J Adv Nurs, 2023, 79(6):2250-2258.
DOI URL |
[6] | 吕文梅, 陈鹏宇, 曾英, 等. 维持性血液透析患者自我调节疲劳现状及影响因素分析[J]. 华西医学, 2022, 37(7):1022-1026. |
Lu WM, Chen PY, Zeng Y, et al. Analysis of current situation and influencing factors of self-regulatory fatigue in maintenance hemodialysis patients[J]. West China Med J, 2022, 37(7):1022-1026. | |
[7] | 徐静, 王娟, 张金俊, 等. 血液透析患者自我调节疲劳现状及影响因素分析[J]. 护理学, 2022, 11(2):160-167. |
Xu J, Wang J, Zhang JJ, et al. Status quo and its influencing factors of self-regulating fatigue in hemodialysis patients[J]. Nurs Sci, 2022, 11(2):160-167. | |
[8] | 周蕊, 宋新灵, 郄淑文, 等. 腹膜透析病人自我调节疲劳现状及影响因素[J]. 护理研究, 2022, 36(23):4259-4262. |
Zhou R, Song XL, Qie SW, et al. Status quo and influencing factors of self-regulation fatigue in peritoneal dialysis patients[J]. Chin Nurs Res, 2022, 36(23):4259-4262. | |
[9] |
Brown DMY, Graham JD, Innes KI, et al. Effects of prior cognitive exertion on physical performance:a systematic review and meta-analysis[J]. Sports Med, 2020, 50(3):497-529.
DOI |
[10] | Davis A, Cohen E. The effects of social support on strenuous physical exercise[J]. Adapt Hum Behav Physiol, 2018, 4(2):171-187. |
[11] |
Englert C. Ego depletion in sports:highlighting the importance of self-control strength for high-level sport performance[J]. Curr Opin Psychol, 2017, 16:1-5.
DOI PMID |
[12] |
上海慢性肾脏病早发现及规范化诊治与示范项目专家组,高翔,梅长林. 慢性肾脏病筛查诊断及防治指南[J]. 中国实用内科杂志, 2017, 37(1):28-34.
DOI |
Shanghai Chronic Kidney Disease Early Detection and Standardized Diagnosis and Treatment and Demonstration Project Expert Group,Gao X,Mei CL. Guideline for screening,diagnosis,prevention and treatment of chronic kidney disease[J]. Chin J Pract Intern Med, 2017, 37(1):28-34. | |
[13] | 李晓霞, 周艳妮, 彭小芳, 等. BI评定量表在非神经系统疾病患者功能状态评估及护理分级确定中应用的范围综述[J]. 现代临床护理, 2021, 20(5):53-60. |
Li XX, Zhou YN, Peng XF, et al. Barthel Index in assessment of functional status and determination of nursing grading in patients with non-nervous diseases:a review of application scope[J]. Modern Clinical Care, 2021, 20(5):53-60. | |
[14] | 倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380. |
Ni P, Chen JL, Liu N. The sample size estimation in quantitative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380. | |
[15] | 王利刚, 张静怡, 王佳, 等. 自我调节疲劳量表中文版测评青年人的效度与信度[J]. 中国心理卫生杂志, 2015, 29(4):290-294. |
Wang LG, Zhang JY, Wang J, et al. Validity and reliability of the Chinese version of the Self-Regulatory Fatigue Scale in young adults[J]. Chin J Mental Health, 2015, 29(4):290-294. | |
[16] |
Weisbord SD, Fried LF, Arnold RM, et al. Development of a symptom assessment instrument for chronic hemodialysis patients:the dialysis symptom index[J]. J Pain Symptom Manag, 2004, 27(3):226-240.
DOI PMID |
[17] | 郝艳华, 姜亚芳. 维持性血液透析患者症状经历的调查研究[J]. 中华护理杂志, 2016, 51(3):299-303. |
Hao YH, Jiang YF. Symptom experiences among maintenance hemodialysis patients:a cross sectional study[J]. Chin J Nurs, 2016, 51(3):299-303. | |
[18] |
Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism(and trait anxiety,self-mastery,and self-esteem):a reevaluation of the Life Orientation Test[J]. J Pers Soc Psychol, 1994, 67(6):1063-1078.
DOI PMID |
[19] |
Lai JCL, Yue X. Measuring optimism in Hong Kong and Mainland Chinese with the revised Life Orientation Test[J]. Personal Individ Differ, 2000, 28(4):781-796.
DOI URL |
[20] |
Zimet GD, Powell SS, Farley GK, et al. Psychometric characteristics of the multidimensional scale of perceived social support[J]. J Pers Assess, 1990, 55(3/4):610-617.
DOI URL |
[21] | 姜乾金. 领悟社会支持量表[J]. 中国行为医学科学, 2001, 10(10):41-43. |
Jiang QJ. Perceived Social Support Scale[J]. Behav Med Sci China, 2001, 10(10):41-43. | |
[22] |
Broadbent E, Petrie K, Main J, et al. The Brief Illness Perception Questionnaire[J]. J Psychosom Res, 2006, 60(6):631-637.
DOI PMID |
[23] | 梅雅琪, 李惠萍, 杨娅娟, 等. 中文版疾病感知问卷简化版在女性乳腺癌患者中的信效度检验[J]. 护理学报, 2015, 22(24):11-14. |
Mei YQ, Li HP, Yang YJ, et al. Reliability and validity of Chinese version of the Brief Illness Perception Questionnaire in patients with breast cancers[J]. J Nurs, 2015, 22(24):11-14. | |
[24] |
Feifel H, Strack S, Nagy VT. Coping strategies and associated features of medically ill patients[J]. Psychosom Med, 1987, 49(6):616-625.
DOI PMID |
[25] | 沈晓红, 姜乾金. 医学应对方式问卷中文版701例测试报告[J]. 中国行为医学科学, 2000, 9(1):18-20. |
Shen XH, Jiang QJ. Report on application of Chinese version of MCMQ in 701 patients[J]. Chin J Behav Med Sci, 2000, 9(1):18-20. | |
[26] | 周越, 单岩, 李艳艳, 等. 自我调节疲劳对腹膜透析患者疾病管理积极度的影响[J]. 护理学杂志, 2020, 35(15):34-36. |
Zhou Y, Shan Y, Li YY, et al. Impact of self-regulatory fatigue on activation level among peritoneal dialysis patients[J]. J Nurs Sci, 2020, 35(15):34-36. | |
[27] |
Lu MX, Yang YY, Wang GM, et al. Effects of perceived stigma on depressive symptoms and demoralization in maintenance hemodialysis patients:self-warmth and self-coldness as mediators[J]. Mindfulness, 2022, 13(12):3058-3069.
DOI |
[28] | 乔建歌, 杨青敏. 慢性病患者乐观心理的研究进展[J]. 中华护理杂志, 2014, 49(5):592-596. |
Qiao JG, Yang QM. Optimism in patients with chronic diseases:a review[J]. Chin J Nurs, 2014, 49(5):592-596. | |
[29] | 陈晨. 肺癌患者疾病获益感现状及其影响因素研究[D]. 扬州: 扬州大学, 2022. |
Chen C. Study on the status quo of patients with lung cancer’s sense of disease benefit and its influencing factors[D]. Yangzhou: Yangzhou University, 2022. |
[1] | 马景双, 王爱平, 王艳杰, 李魏, 刘艳霞. 基于前哨症状的肺癌术后化疗患者护理干预方案的构建及应用[J]. 中华护理杂志, 2024, 59(2): 133-141. |
[2] | 吴国凤, 李芯睿, 钟美容, 杨琳, 程树锦, 陈岩, 钟静静, 孙瑞. 基于云平台的延续护理对乳腺癌患者阈下抑郁影响的研究[J]. 中华护理杂志, 2024, 59(2): 142-148. |
[3] | 何佩佩, 陈丽, 孙淼娟, 胡丽君, 殷晓红. 基于系统教学模式的腹膜透析患者再培训方案的构建及应用[J]. 中华护理杂志, 2024, 59(2): 149-155. |
[4] | 龚艳琳, 郜欣悦, 陈静, 刘玲玲, 吴菁, 李永琦, 储静. 维持性血液透析患者益处发现体验的质性研究[J]. 中华护理杂志, 2024, 59(2): 164-169. |
[5] | 李明妍, 路遥, 张美斌, 李思怡. 1例动静脉内瘘扣眼穿刺处内膜增生患者的护理[J]. 中华护理杂志, 2024, 59(2): 170-173. |
[6] | 朱东阁, 王菊子, 赵倩, 何亚鹏, 张转转, 杨雨桐. 维持性血液透析患者透析中低血压风险预测模型的系统评价[J]. 中华护理杂志, 2024, 59(2): 174-183. |
[7] | 俞晓晶, 徐雪芬, 许莉莉, 田燕萍, 樊丹凤, 冯素文. 基于虚拟现实技术的产前健康教育课程的构建及应用[J]. 中华护理杂志, 2024, 59(2): 184-190. |
[8] | 王悦, 刘飞, 朱丹, 王影新, 谷洪涛, 万巧琴. 乳腺癌患者同伴教育者总体幸福感现状及影响因素研究[J]. 中华护理杂志, 2024, 59(2): 191-196. |
[9] | 刘雪冰, 许亚红, 闫煜然. 家庭签约护士工作体验的质性研究[J]. 中华护理杂志, 2024, 59(2): 197-202. |
[10] | 骆雅萍, 于淑娟, 朱苗苗, 潘红英. 社区老年糖尿病患者自我忽视的诠释性现象学研究[J]. 中华护理杂志, 2024, 59(2): 203-209. |
[11] | 钱丽清, 陆晓燕, 李丽玲, 蒋思远, 胡晓静. 1例重度支气管肺发育不良早产儿从医院到家庭过渡期的护理[J]. 中华护理杂志, 2024, 59(2): 210-213. |
[12] | 潘陈伟, 王文春, 陈管洁, 李晓青. 5例重度急性呼吸窘迫综合征合并高碳酸血症患者行体外二氧化碳清除治疗的护理[J]. 中华护理杂志, 2024, 59(2): 214-218. |
[13] | 于万慧, 崔朝妹, 迟嘉婧, 靳子恒, 苟晓瑜, 李梦洁, 卢楠, 杨丽娟. 先天性心脏病青少年向成人过渡治疗及护理体验的Meta整合[J]. 中华护理杂志, 2024, 59(2): 219-227. |
[14] | 季谋芳, 李若冰, 胡廷进, 陈静怡. 不同非药物干预方式对产后抑郁症患者影响的网状Meta分析[J]. 中华护理杂志, 2024, 59(2): 228-235. |
[15] | 台瑞, 方芳, 杨富, 余倩. 择期胃肠道手术患者预康复的最佳证据总结[J]. 中华护理杂志, 2024, 59(2): 236-243. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||