维持性血液透析患者生活质量满意度及影响因素分析

Analysis on the satisfaction of the quality of life and related factors in maintenance hemodialysis patients

目的了解维持性血液透析患者生活质量状况,探索其影响因素,促进患者生活质量的提升。方法采用随机整群抽样的方式抽取徐州市第一人民医院112例进行维持性血液透析的患者,应用生活满意度量表进行问卷调查。结果超过半数患者对目前的生活不满意并感到精神有压力,80.36%对治疗缺乏信心,87.50%不能或不愿意参加社会活动,91.96%感到生活不便,82.14%需要动用家庭经济储备支付透析费用,67.86%需要亲戚、朋友帮助维持透析,79.46%日常支出习惯受到影响,75.89%透析费用能够报销或部分报销。其中遇到问题时不能得到家人满意帮助、与兄弟姐妹不经常联系、与朋友不经常联系、与邻居不经常聊天、对未来没有信心、医疗费用高、对费用报销比例不满意等是影响维持性血液透析患者生活质量的危险因素。结论目前维持性血液透析患者生活质量总体较差。加大患者家庭支持和社会关注力度,在延长患者生存期的基础上努力提高患者的物质和精神生活质量,同时做好该类人群的心理疏导、构建和谐的人际关系、完善疾病补助机制、提高患者报销比例是改善维持性血液透析患者生活质量的关键。

Objective To investigate the quality of life in maintenance hemodialysis patients and to explore the affecting factors so as to improve the quality of life in the patients.Methods 112 patients with maintenance hemodialysis were selected by random cluster sampling in Xuzhou First People＇s Hospital and were assessed by life satisfaction scale questionnaire.Results The study showed dissatisfaction with the current life and felt stressed in over half of the patients,lack of confidence in the treatment（80.36%）,inability or reluctance to participate in social activities（87.5%）;inconvenience of life（91.96%）,expenditure on dialysis from domestic economic reserves（82.14%）,support from relatives and friends for maintenance dialysis（67.86 %）,impact on daily spending habits（79.46%）,and full or partial reimbursement for dialysis costs（75.89%）.The risk factors affecting the quality of life of maintenance hemodialysis patients included lack of satisfactory help from family members when problems were encountered,infrequent contact with brothers or sisters as well as friends,lack of chat with neighbors,lack of confidence in the future,high medical expenses and dissatisfaction with the proportion of reimbursement for maintenance hemodialysis expenses,etc.Conclusion At present the overall quality of life of maintenance hemodialysis is rather poor,which calls for the enhanced support form family and social concerns.Apart from the extension of the lifespan of the patients,the quality of material and spiritual life should also be improved.Meanwhile,timely psychological counseling for this population and construction of harmonious interpersonal relationship together with the perfection of sickness subsidy system and the increase of the proportional reimbursement for treatment expense all contribute to the improvement of the quality of life of maintenance hemodialysis patients.