腹膜透析患者外出口护理现状及其依从性的影响因素分析

The cross-sectional study of exit site care and compliance in patients on peritoneal dialysis

目的调查腹膜透析患者外出口护理现状及影响腹膜透析患者外出口护理依从性的影响因素。方法本研究调查了210例临床稳定透析的腹膜透析患者。通过自设问卷调查外出口护理现状及依从性,记录患者的人口学资料及生化指标。结果 210例患者中有87例(47.4%)自行完成外出口护理。本组患者在外出口护理的6个方面中对外出口观察的依从性较差,明显低于其他方面(P<0.01)。Logistic多元回归分析发现,校正了年龄、性别、血红蛋白、白蛋白及外出口位置和方向后,糖尿病是外出口观察依从性差的独立影响因素(P=0.048)。糖尿病腹膜透析患者更加年老、视力差、营养状况差,更多依赖照顾者来完成外出口护理(P<0.05)。结论腹膜透析患者外出口护理中自我完成情况及外出口观察依从性较差,需要通过护士的培训进一步加强。外出口护理培训,尤其对于糖尿病腹膜透析患者,需要患者及其家属共同参与。

Objective We aimed to investigate the actual situation of exit site care in patients on peritoneal dialysis （PD） and to further determine the factors influencing the compliance with exit site care. Methods A total of 210 clinically stable PD patients were enrolled in this study. A self-designed questionnaire was applied to explore patient＇s exit site care and the compliance with exit site care. The demographic and biochemistry data were also recorded. Results A total of 87 in the 210 patients performed exit site care independently. The compliance with routine exit site observation was significantly worse compared to other aspects （P〈0.001）. Diabetes was the independent predictor for poor compliance with routine exit site observation after adjusted for age, gender, hemoglobin, serum albumin, the location and direction of exit site by using logistic multivariate regression analysis （P=0.048）. Diabetic PD patients were prone to be elder, poor eye-sighted and malnourished （P〈0.05-0.001）. They also tended to need assistants to do exit site care compared to non-diabetic PD patients （P〈0.001）. Conclusion The training of patients needs to be strengthened in the aspect of self-care and routine exit site observation. PD patients, especially diabetic PD patients as well as their fellows or care providers should be involved in the training for exit site care.