维持性血液透析患者失志综合征现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2023.05.009

摘要/Abstract

摘要：

目的调查维持性血液透析（maintenance hemodialysis，MHD）患者失志综合征现状，并分析其影响因素。方法采用便利抽样法，于2021年10月—2022年4月选取湖北省襄阳市16所医院的MHD患者作为调查对象。采用一般资料调查表、中文版失志综合征量表Ⅱ、中文版心理一致感量表、疾病不确定感量表和医学应对方式问卷进行调查。采用多元线性回归分析MHD患者失志综合征的影响因素。结果 1 094例MHD患者中文版失志综合征量表Ⅱ得分为（12.72±7.10）分，其中中度失志占57.04%，重度失志占12.43%。多元线性回归分析结果显示，医疗付费方式、职业状况、睡眠质量、长期口服药物数量、心理一致感、疾病不确定感、医学应对方式是MHD患者失志综合征的影响因素（P<0.05）。结论 MHD患者失志综合征发生率高，心理痛苦有待改善。医护人员应定期对患者的失志综合征水平进行评估，并根据相关影响因素制订针对性的干预措施，以降低患者的失志综合征水平，改善其预后及心理状态。

关键词: 维持性血液透析, 终末期肾病, 失志综合征, 心理一致感, 疾病不确定感, 医学应对方式, 影响因素分析, 横断面研究, 护理

Abstract:

Objective To investigate the status of demoralization syndrome in patients with maintenance hemodialysis disease（MHD） and to analyze the influencing factors. Methods Convenience sampling method was used to select MHD patients from 16 hospitals in Xiangyang，Hubei Province from October 2021 to April 2022. The general information questionnaire，Demoralization Scale-Ⅱ，Sense of Coherence-13，Mishel Uncertainty in Illness Scale，and Medical Coping Modes Questionnaire were used for investigation. Multiple linear regression was used to analyze the influencing factors of demoralization syndrome in patients with maintenance hemodialysis. Results A total of 1094 MHD patients were included in this study，and the DS-Ⅱ score was（12.72±7.10），of which 57.04% were moderately demoralization and 12.43% were severe demoralization. Multiple linear regression analysis revealed that medical payment method，occupational status，sleep quality，quantity of long-term oral medication，sense of coherence，uncertainty in illness，and medical response were the influencing factors of demoralization syndrome（P<0.05）. Conclusion MHD patients have a high incidence of demoralization syndrome，and their psychological distress state needs to be improved. Medical staff should regularly assess the level of demoralization syndrome in patients，and formulate targeted intervention measures according to relevant influencing factors，so as to reduce the level of demoralization syndrome and improve the prognosis and psychological status of patients.

Key words: Maintenance Hemodialysis, End-Stage Renal Disease, Demoralization Syndrome, Sense of Coherence, Uncertainty in Illness, Medical Response, Root Cause Analysis, Cross-Sectional Studies, Nursing Care

凡颖, 邢利民, 高淑平, 武云云, 周玉梅. 维持性血液透析患者失志综合征现状及影响因素分析[J]. 中华护理杂志, 2023, 58(5): 572-579.

FAN Ying, XING Limin, GAO Shuping, WU Yunyun, ZHOU Yumei. The status and influencing factors of demoralization syndrome in patients with maintenance hemodialysis disease[J]. Chinese Journal of Nursing, 2023, 58(5): 572-579.

图/表 4

表1 维持性血液透析患者中文版失志综合征量表Ⅱ得分情况（分，n=1 094）

Table 1 Score of Chinese version of Demoralization Scale-Ⅱ in maintenance hemodialysis patients（score，n=1 094）

表2 维持性血液透析患者的一般资料及失志综合征单因素分析结果（n=1 094）

Table 2 The general data of subjects and univariate analysis of demoralization syndrome for patients with maintenance hemodialysis（n=1 094）

表3 分类变量赋值方式

Table 3 Categorical variable assignment method

表4 维持性血液透析患者失志综合征影响因素的多元线性回归分析结果（n=1 094）

Table 4 Results of multiple linear regression analysis of factors influencing demoralization syndrome in patients with maintenance hemodialysis（n=1 094）

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