维持性血液透析患者容量管理行为潜在剖面分析及影响因素研究

doi:10.3761/j.issn.0254-1769.2026.01.016

摘要/Abstract

摘要：

目的运用潜在剖面分析法对维持性血液透析（maintenance hemodialysis，MHD）患者容量管理行为的群体特征进行分类，并探讨各潜在类别的影响因素。方法便利选取2024年3月—2025年3月在安徽省某三级甲等医院接受治疗的304例门诊规律血液透析患者作为调查对象，采用一般资料调查表、维持性血液透析患者容量管理行为量表、医院焦虑抑郁量表、家庭关怀度指数问卷以及一般自我效能感量表对其进行问卷调查。采用潜在剖面分析和多元Logistic回归分析MHD患者容量管理行为的潜在剖面及其影响因素。结果本研究共回收有效问卷278份，有效问卷回收率为91.45%。MHD患者容量管理行为可分为低管理行为组（23.74%）、中等管理行为组（56.48%）、高管理行为组（19.78%） 3个潜在类别。透析前血压、透析间期体重增长、文化程度、透析龄、家庭关怀度、一般自我效能是维持性血液透析患者容量管理行为潜在剖面的影响因素（均P<0.05）。结论 MHD患者在容量管理方面的行为存在群体差异性。医护人员可以根据MHD患者容量管理行为不同剖面的类别特征及影响因素，制订针对性的护理干预策略，提高患者的生存质量。

关键词: 维持性血液透析, 容量管理行为, 潜在剖面分析, 影响因素分析, 护理

Abstract:

Objective To identify and classify the population characteristics of volume management behaviors in patients undergoing maintenance hemodialysis（MHD） using latent profile analysis（LPA），and to explore the influen-cing factors for each latent profile. Methods A convenience sample of 304 outpatients receiving regular hemodialysis at a tertiary hospital in Anhui Province，were recruited between March 2024 and March 2025. Participants completed questionnaires including a General Information Questionnaire，the Volume Management Behavior Scale for MHD Patients，the Hospital Anxiety and Depression Scale（HADS），the Family APGAR Index，and the General Self-Efficacy Scale（GSES）. Latent Profile Analysis and Multivariate Logistic Regression were employed to analyze the latent profiles of volume management behaviors and their influencing factors among MHD patients. Results A total of 278 valid questionnaires were collected，yielding an effective response rate of 91.45%. LPA revealed 3 distinct latent profiles of volume management behaviors：low management behavior group（23.74%），moderate management behavior group（56.48%），and high management behavior group（19.78%）. Pre-dialysis blood pressure，interdialytic weight gain，educational attain-ment，dialysis vintage，family support，and general self-efficacy are factors influencing the latent profiles of fluid management behaviors in maintenance hemodialysis patients（P<0.05）. Conclusion Significant group heterogeneity exists in volume management behaviors among MHD patients. Healthcare professionals can utilize the distinct category characteristics and influencing factors associated with these different behavioral profiles to formulate targeted nursing intervention strategies，ultimately improving patients’ quality of life.

Key words: Maintenance Hemodialysis, Volume Management Behaviors, Latent Profile Analysis, Root Caused Analysis, Nursing Care

李奎, 潘爱红, 徐佩丽, 许采颉, 任汝南, 王春. 维持性血液透析患者容量管理行为潜在剖面分析及影响因素研究[J]. 中华护理杂志, 2026, 61(1): 113-120.

LI Kui, PAN Aihong, XU Peili, XU Caijie, REN Runan, WANG Chun. Latent profile analysis and influencing factors of volume management behaviors in maintenance hemodialysis patients[J]. Chinese Journal of Nursing, 2026, 61(1): 113-120.

图/表 6

表1 维持性血液透析患者的一般资料及容量管理行为潜在剖面的单因素分析

Table 1 General information and univariate analysis of potential profiles of volume management behavior among maintenance hemodialysis patients

表2 维持性血液透析患者容量管理行为量表条目得分情况

Table 2 Scores of individual items on the Volume Management Behavior Scale for maintenance hemodialysis patients

表3 维持性血液透析患者容量管理行为潜在剖面模型的拟合指标（n=278）

Table 3 Model fitting results of potential profile analysis model for volume management behavior among maintenance hemodialysis patients（n=278）

图1 维持性血液透析患者容量管理行为3个潜在剖面的特征分布

Figure 1 The characteristic distribution of 3 potential profiles of volume management behavior among maintenance hemodialysis patients

表4 自变量赋值方式

Table 4 Assignment of independent variables

表5 维持性血液透析患者容量管理行为潜在剖面的多因素分析（n=278）

Table 5 Multifactor analysis of potential profiles of volume management behavior among maintenance hemodialysis patients（n=278）

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