维持性血液透析患者希望状况及影响因素

The current status and influential factors of hope in maintenance hemodialysis patients

目的调查维持性血液透析患者希望状况并探讨其影响因素。方法采用自行设计的患者一般情况调查表、中文版Herth希望量表、透析患者症状困扰量表、简易应对方式问卷、社会支持量表对广州市3所“三甲”医院血液透析中心的182名维持性血液透析患者进行调查。结果维持性血液透析患者希望的总体均分为（31．83±3．69）分，87．91％的患者希望水平处于中等。症状有无、症状困扰程度、积极、消极应对方式、社会支持总体均分分别为（13．44±5．63）分、（35．27±18．51）分、（2．15±0．28）分、（1．56±0．33）分、（42．24±4．09）分；症状有无、症状困扰程度、消极应对对患者希望水平有显著负向影响，标准回归系数分别为～0．098，-0．424，-0．104，P=0．047～0．000，积极应对方式、社会支持对希望水平有显著正向影响，标准回归系数分别为0．183，0．226，P=0．000，它们可以解释希望水平总变异的96．2％。结论维持性血液透析患者希望水平处于中等，症状困扰、社会支持、应对方式是希望水平的主要影响因素。

Objective To investigate the current status of hope in maintenance hemodialysis patients and analyze its influential factor,in order to provide reference for effective intervention. Methods A total of 182 maintenance hemodialysis patients were recruited from 3 dialysis centers in Guangzhou and were investigated with the self-designed questionnaire, dialysis symptom Index, the Herth hope scale, simplified coping scale and social support scale. The data were analyzed by single-factor and multiple-factor analysis. Results The average score of hope in maintenance hemodialysis patients was 31.83 ± 3.69,and 87.91% of patients got a moderate hope level. The average scores of present of symptom distress, degree of distress, active coping style, passive coping style and social support were 13.44 ± 5.63,35.27±18.51,2.15 ± 0.28,1.56 ± 0.33 and 42.24 ± 4.09 respectively. Mul- tiple linear regression indicated that symptoms presence, the symptoms distress degree, the passive coping style were the risk factors of hope level and the standard regression coefficient were - 0. 098, - 0. 424, - 0. 104, P = 0. 047 -0.000. The social support and the active coping style were the protective factors of hope level and the standard regression coefficient were 0. 183,0. 226, P=0. 000. And they explained 96.2% of the variance. Conclusion The level of hope in maintenance hemodialysis patients is moderate. Symptom distress, the coping style and social support are factors influencing hope level of patients.