影响血液透析病人舒适度的相关因素调查与对策

Investigation of comfort degree in hemodialysis patients and the strategies

目的探讨影响诱导期血液透析和维持性血液透析病人舒适度的相关因素,并提出针对性的对策。方法采用美国国立卫生研究院制定的视觉模拟评分法(Visual analogue sclale,VAS)测评病人的舒适度,采用自行设计的调查表,调查影响病人舒适度的相关因素。结果诱导期血液透析和维持性血液透析病人舒适度分别为19%和32%。两种透析方法下其舒适度比较,经统计学分析,χ2=3.908,P<0.05,差异有统计学意义。诱导期透析病人在生理因素的3个方面(穿刺、拔针疼痛,恶心、呕吐,体位不适)以及心理方面的不舒适感明显高于维持性透析病人;而维持性透析病人在社会需求方面比诱导期透析病人的不舒适程度高,经统计学分析,均P<0.05,差异有统计学意义。结论根据影响血液透析病人舒适度相关的因素,采取不同的舒适护理,可提高血液透析病人的舒适度和生活质量。

Objective To explore the related factors affecting comfort degree of the hemodialysis （HD） patient, and put forward the strategies. Methods The visual analogue scale （VAS） by American NHI was used to determine the patient＇s comfort degree. A self-designed questionnaire was used to investigate the related factors affecting the comfort degree of 100 hemodialysis patients at the induction period and 75 at maintenance hemodialysis period. Results The comfort degree of the HD patients at the induction period and the maintenance period remained 19% and 32% respectively. Three physical factors at the induction period （pains at puncturing and withdrawing needs, nausea and vomiting and discomfort at body positions） and mental disconiforts were significantly higher than those at maintenance period. The discomfort degree of those at maintenance period was significantly higher that those at induction period（P 〈 0.05）. Conclusions The comfort and life quantity of the HD patients can be improved by adopting different and comfort nursing according to the related factors affecting the HD patients＇ comfort degree.