双向社会支持在老年维持性血液透析患者中的应用研究

doi:10.3761/j.issn.0254-1769.2025.07.007

摘要/Abstract

摘要：

目的探讨基于幸福理论模式的双向社会支持对老年维持性血液透析患者总体幸福感和社会支持的影响，为提升其幸福感和社会支持水平提供参考。方法采用便利抽样法，选取2022年1月—12月浙江省湖州市某三级甲等医院血液净化中心60例老年维持性血液透析患者作为研究对象，根据患者所处病区不同，随机分为试验组或对照组，两组分别纳入30例患者。试验组在常规护理的基础上实施为期4周的基于幸福理论模式的双向社会支持干预方案，对照组实施常规护理。于干预前、干预4周和干预后1个月采用总体幸福感量表、社会支持量表、睡眠时长、活动时长评价干预效果。结果重复测量方差分析结果显示，总体幸福感得分、社会支持得分、睡眠时长、活动时长在时间效应方面，差异有统计学意义（P<0.05），总体幸福感得分、社会支持得分、睡眠时长在组间效应方面，差异有统计学意义（P<0.05），社会支持得分、睡眠时长在交互效应方面差异具有统计学意义（P<0.05）。结论基于幸福理论模式的双向社会支持可以增强老年维持性血液透析患者的总体幸福感和社会支持水平，改善其睡眠和活动情况。

关键词: 积极心理干预, 社会支持, 维持性血液透析, 心理护理

Abstract:

Objective To explore the basis of PERMA on the overall well-being and social support of elderly patients with maintenance hemodialysis（MHD）. Methods A total of 60 elderly patients with MHD were selected from the blood purification center of a tertiary A hospital in Zhejiang Province from January to December 2022 as the study subjects. According to the different disease areas of the patients，they were randomly divided into an experimental group or a control group. Finally，30 patients were included in each group. The control group received routine care，and the experimental group received another 4-week bidirectional social support intervention based on the PERMA model. General well-being scale，social support rating scale，sleep duration，activity duration were used to evaluate the effect before intervention，4 weeks after intervention and 1 month after intervention. Results The results of repeated measurement ANOVA showed that there were statistically significant differences in general happiness score，social support score，sleep duration and activity duration in terms of time effect（P<0.05），while there were statistically significant differences in general happiness score，social support score and sleep duration in terms of inter-group effect（P<0.05）. Social support score and sleep duration had statistically significant interac-tion effects（P<0.05）. Conclusion The bidirectional social support intervention based on well-being PERMA model can enhance the general well-being and social support level of elderly patients with MHD，and improve the sleep and activity status of elderly patients with MHD.

Key words: Positive Psychological Intervention, Social Support, Maintenance Hemodialysis, Psychological Nursing

张程, 王霄一, 杨文娟, 刘梦如, 贺飞. 双向社会支持在老年维持性血液透析患者中的应用研究[J]. 中华护理杂志, 2025, 60(7): 813-818.

ZHANG Cheng, WANG Xiaoyi, YANG Wenjuan, LIU Mengru, HE Fei. Application of bidirectional social support in elderly patients with maintenance hemodialysis[J]. Chinese Journal of Nursing, 2025, 60(7): 813-818.

图/表 5

表1 基于幸福理论模式的双向社会支持干预方案

Table 1 Bidirectional social support intervention program based on the PERMA model

表2 两组一般资料比较[例（百分比，%）]

Table 2 Comparison of general data in the 2 groups[case（percentage，%）]

表3 两组总体幸福感评分的比较（分，$\bar{x}±s$）

Table 3 Comparison of general happiness scores between the 2 groups（score，$\bar{x}±s$）

表4 两组社会支持评分的比较（分，$\bar{x}±s$）

Table 4 Comparison of social support scores between the 2 groups（score，$\bar{x}±s$）

表5 两组客观指标的比较（$\bar{x}±s$）

Table 5 Comparison of objective indicators between the 2 groups（$\bar{x}±s$）

参考文献 18

[1]	张娥, 何学勤, 黄肖容, 等. 尿毒症病人绝望水平及其影响因素[J]. 护理研究, 2019, 33(9):1568-1571.
	Zhang E, He XQ, Huang XR, et al. Despair level and its influencing factors of uremic patients[J]. Chin Nurs Res, 2019, 33(9):1568-1571.
[2]	曲盛美, 齐向秀, 李群, 等. 积极心理干预在永久性肠造口患者中的应用研究[J]. 中华护理杂志, 2024, 59(12):1422-1428. DOI URL
	Qu SM, Qi XX, Li Q, et al. Effects of positive psychological intervention in patients with permanent enterostomy[J]. Chin J Nurs, 2024, 59(12):1422-1428. DOI URL
[3]	燕美琴, 闫高慧, 任永莲, 等. 积极心理干预对孕妇分娩恐惧和总体幸福感的影响[J]. 中华护理杂志, 2022, 57(24):2957-2963. DOI URL
	Yan MQ, Yan GH, Ren YL, et al. Effects of positive psychological interventions on maternal labor fear and general well-being[J]. Chin J Nurs, 2022, 57(24):2957-2963. DOI URL
[4]	Fang HJ, Zeng YL, Liu YY, et al. The effect of the PERMA model-based positive psychological intervention on the quality of life of patients with breast cancer[J]. Heliyon, 2023, 9(6):e17251.
[5]	尹艳茹, 周洪昌, 刘梦如, 等. 老年维持性血液透析患者社会隔离现状的调查研究[J]. 中华护理杂志, 2023, 58(7):822-829. DOI URL
	Yin YR, Zhou HC, Liu MR, et al. Status and influencing factors of social isolation in elderly patients with maintenance hemodialysis[J]. Chin J Nurs, 2023, 58(7):822-829. DOI URL
[6]	吴玉霄, 孙清, 崔立敏. 老年人社会衰弱现状及干预研究进展[J]. 中国老年保健医学, 2024, 22(4):126-129.
	Wu YX, Sun Q, Cui LM. Research progress of social frailty in the elderly and its intervention[J]. Chin J Ger Care, 2019, 22(4):126-129.
[7]	赵新菊, 左力. KDOQI血液透析充分性临床实践指南2015更新版-开始血液透析的时机解读[J]. 中国血液净化, 2016, 15(8):385-387.
	Zhao XJ, Zuo L. KDOQI clinical practice guidelines for hemodialysis adequacy 2015 update:interpretation of the timing of starting hemodialysis[J]. Chin J Blood Purif, 2016, 15(8):385-387.
[8]	Fredrickson BL. What good are positive emotions?[J]. Rev Gen Psychol, 1998, 2(3):300-319. DOI PMID
[9]	Duan XY, Wang XH, Li XG, et al. Effect of mass sports activity on prosocial behavior:a sequential mediation model of flow trait and subjective wellbeing[J]. Front Public Health, 2022, 10:960870.
[10]	段建华. 总体幸福感量表在我国大学生中的试用结果与分析[J]. 中国临床心理学杂志, 1996(1):56-57.
	Duan JH. Trial results and analysis of Global Happiness Scale in Chinese college students[J]. Chin J Clin Psych, 1996(1):56-57.
[11]	王悦, 刘飞, 朱丹, 等. 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):191-197. DOI
	Wang Y, Liu F, Zhu D, et al. Study on the status quo and influencing factors of the overall well-being of peer educators of breast cancer patients[J]. Chin J Nurs, 2019, 59(2):191-197.
[12]	肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994(2):98-100.
	Xiao SY. The theoretical basis and research application of Social Support Rating Scale[J]. J Clin Psy, 1994(2):98-100.
[13]	王静怡, 李一章, 马彬, 等. 高龄产妇产褥期疲乏现状及影响因素分析[J]. 中华护理杂志, 2023, 58(11):1292-1297. DOI URL
	Wang JY, Li YZ, Ma B, et al. Analysis of the current status of puerperal fatigue in women at advanced maternal age and its influencing factors[J]. Chin J Nurs, 2023, 58(11):1292-1297. DOI URL
[14]	王佳佳. PERMA模式下的积极心理干预对乳腺癌患者癌症复发恐惧的影响[D]. 衡阳: 南华大学, 2021.
	Wang JJ. Effect of positive psychological intervention under PERMA mode on cancer recurrence fear of breast cancer patients[D]. Hengyang: University of South China, 2021.
[15]	毛燕辉, 郝子怡, 王淑君, 等. 心流体验提升大学生的主观幸福感:基于周记法的证据[J]. 中国健康心理学杂志, 2024, 32(3):345-351.
	Mao YH, Hao ZY, Wang SJ, et al. Flow experience fosters sub-jective well-being of undergraduates:empirical evidence based on weekly-diary approach[J]. China J Health Psychol, 2024, 32(3):345-351.
[16]	王琳. 重大疾病家庭照顾者社会支持的干预研究[D]. 上海: 华东理工大学, 2019.
	Wang L. Intervention research on social support for family caregivers with serious diseases[D]. Shanghai: East China Univ ersity of Science and Technology, 2019.
[17]	吴九君. 积极心理干预对大学生睡眠质量、正性情感、抗逆力、心理和谐、总体幸福感的提升效果[J]. 中国健康心理学杂志, 2024, 32(8):1268-1274.
	Wu JJ. Effects of positive psychological intervention on improving sleep quality,positive emotion,resilience,psychological harmony and overall happiness of college students[J]. Chin J Health Psych, 2019, 32(8):1268-1274.
[18]	徐茗珊. 青岛市老年人体育锻炼对心理幸福感多组态影响:基于定性比较分析法[D]. 曲阜: 曲阜师范大学, 2024.
	Xu MS. Multi-configuration influence of physical exercise on psychological well-being of the elderly in Qingdao:based on qualitative comparative analysis[D]. Qufu: Qufu Normal University, 2024.