长期血液透析患者心理压力应对方式及其影响因素的调查研究

Coping strategies among patients receiving continuous hemodialysis

目的探索接受持续性血液透析的患者对压力的应对方式极其影响因素。方法研究采用描述性相关性设计 ,应对方式以Jalowiec应对方式量表 (JalowiecCopingScale)量度。结果乐观应对方式为本研究中最多患者采用的方式。年龄和并发症因素影响患者是否应用乐观应对 (P<0.01);年龄因素影响逃避应对的应用 (P<0.05):60岁以上的患者较中青年患者少应用此方法 (P<0.005);自助应对方式的应用受疾病的严重程度和患者的教育程度影响 (P<0.05);患者的职业影响其是否寻求帮助 (P<0.05) ;掩饰方式的采用受疾病的严重程度和医疗费用的支付方式影响 (P<0.05)。悲观应对为女性患者第二位最常用的方式。结论患者的应对方式呈多样性。年龄、性别、教育程度、职业、疾病的严重程度及医疗费用的支付方式显著影响应对方式。在探究持续性血液透析患者的应对方式时 ,医务人员有责任协助患者采用积极的应对方式应付这个压力源。对于女性患者 ,更应注意评估其应对方式 ,协助她们采取积极的应对方式 ,以提高长期透析患者的生存质量。

Objective To explore coping strategies of patients undergoing continuous hemodialysis.Methods A descriptive design was used to conduct this study.The purposive sampling method was used to select study samples.A total of41patients on continuous hemodialysis were included in the study.The coping was measured on the Jalowiec Coping Scale.Results The optimal coping style was the most used by par-ticipants in the study,followed by fatalistic,confronting,self-reliant,emotional,supportive,evasive,and palliative coping styles.The optimal copingmethodwaseffectedbyageandcomplication(P<0.01).Agewastheinfluencingfactorfortheevasivecopingmethod(P<0.05).Participants more than60years of age were less likely to use this method than middle-aged and young patients(P<0.05).The self-reliant coping method was effected by the severity of disease and the education level of the participants(P<0.05).The severity of disease and hospital fee payment influenced patients using the palliative coping method(P<0.05).The fatalistic coping method was the second most commonly used by women in this study.Conclusion The results showed that patients used various types of coping strategies.Age,sex,educational level,oc-cupation,severity of health condition,and manner of hospital payment had significant influence on the coping style.To probe the coping style of continuous hemodialysis patients,nurses have the responsibility of helping patients to use positive coping methods to deal with the stress.Nurses also need to give attention to assessing the coping style of women receiving continuous hemodialysis to assist them in using a positive method.