慢性肾衰竭患者透析遵医行为的影响因素分析

AFFECTING FACTORS OF COMPLIANCE ON DIALYSIS IN CHRONIC RENAL FAILURE PATIENTS

目的：探讨慢性肾衰竭接受透析患者遵医行为的影响因素，为合理制定慢性肾衰竭透析患者的护理方式、提高患者依从性及治疗效果提供依据。方法收集患者的临床资料，分析年龄、学历、心理情绪、透析年龄、对医务人员的信任度、职业、经济状况等多个方面对遵医行为的影响。结果遵医行为好的年龄分组依次为﹥40-60岁、﹥60-80岁、﹥18-40岁，学历分组依次为大学及以上、初中至高中、小学及以下，焦虑量表分组依次为﹤14分、≥14-28分、≥29分，抑郁量表分组依次为﹤7分、≥7-13分、≥14分，透析年龄分组依次为≤1年、﹥1-3年、﹥3年，对医务人员的信任度分组次次为良好、一般、较差，职业分组依次为职业白领、公务员、农民，经济状况分组依次为完全满足、一般满足、无法满足，差异有统计学意义（P ﹤0.01）。多因素 Logistic 回归分析显示透析患者的遵医行为与年龄、学历、焦虑程度、抑郁程度、透析年龄、对医务人员的信任度、经济状况和职业均密切相关（P ﹤0.05）。结论年龄、学历、心理情绪、透析年龄、对医务人员的信任度、职业、经济状况等因素对慢性肾衰竭透析患者的遵医行为均产生较大影响，医务人员应当根据不同患者因人而异地制定治疗方案和护理措施，从而有利于改善患者的遵医行为，提高治疗效果。

Objective To explore the factors affecting the compliance of dialysis in chronic renal failure patients,and to provide the basis for rational improvement in the care approach of chronic renal failure patients undergoing dialysis. Methods The patients＆#39; informations were collected to analyze the relationship between patients＆#39; compliance and age,educational condition,psychological and emotional condition,dialysis duration,trust in the medical staff,occupational and economic status. Results In accordance with compliance behaviors,the patients were divided into the following groups based on age （ ﹥ 18 - 40 years,﹥ 40 - 60 years and ﹥ 60 - 80 years）,educational background（ preliminary school and below,middle school and high school and university and above）,Hamilton Dysphoria Questionnaire （ ﹤ 14 scores,≥14 - 28 scores,≥29 scores）,Hamilton Depression Questionnaire（ ﹤ 14 scores,≥14 -28 scores and ≥29 scores）,dialysis duration（ ≤1 year,﹥ 1 - 3 years and ﹥ 3 years）,trust in the medical staff（ good,average and poor）,occupation（ public servant,white collar and farmer） and economic status（ completely satisfied,averagely satisfied and unsatisfied）. The patients＆#39; compliance behaviors were all satistically different among these groups（ P ﹤ 0. 01 ）. Logistic regression analysis showed that the compliance of dialysis in chronic renal failure patients was associated with age, educational background,Hamilton Dysphoria Questionnaire,Hamilton Depression Questionnaire,dialysis duration,trust in the medical staff,occupation and economic status（ P ﹤ 0. 05）. Conclusion Age, educational condition,psychological and emotional condition,dialysis duration,trust in the medical staff, occupational and economic status are all factors that affect a better degree of patient compliance behavior. The formulating of treatment plan and care measures should be individualized,thus improving to patients＆#39; compliance behavior,the therapeutic effect.