理性情绪疗法对维持性血液透析患者生活质量的影响

Effect of Rational-Emotive Therapy on Quality of Life in Maintenance Hemodialysis Patients

目的探讨理性情绪疗法对维持性血液透析(maintenance hemodialysis,MHD)患者生活质量的改善作用。方法以86例MHD患者为研究对象,随机分为干预组和对照组。应用理性情绪疗法干预患者,记录患者一般临床资料、常用血生化指标和治疗依从性;采用肾病与生活质量简短版量表(KDQOL-SFTM1.3量表)评定MHD患者生活质量。比较理性情绪疗法干预前后患者临床生化指标变化和生活质量评分情况。结果与对照组比较,干预组患者治疗后透析频次增加(81.4%vs.60.47%),饮食控制(79.07%vs.48.84%)、主动咨询(100%vs.65.12%)和参与社会活动增多(65.12%vs.25.58%),透析间期水分控制和透析充分性改善,血压、血肌酐和iPTH明显下降,血红蛋白显著上升(P<0.05)。SF-36总评分(64.75±10.02 vs.55.31±10.89)和KDTA总评分(62.62±12.26 vs.53.38±12.04)显著升高,生理机能、生理职能、情感状况、情感职能、症状与不适、肾病对生活影响、工作状况、性功能和睡眠状态显著改善(P<0.05)。SF-36总评分和KDTA总评分与Kt/v和血红蛋白显著正相关,与收缩压、血肌酐和iPTH显著负相关(P<0.05)。结论理性情绪疗法可能通过纠正负性心理反应,改善相关生化指标,逐渐提高患者的生活质量。

Objective To explore the effect of rational-emotive therapy on quality of life in maintenance hemodialysis（MHD）patients.Methods Eighty-six MHD patients were divided randomly into therapy group and control group.Therapy group accepted rational-emotive therapy for one year.Clinical data and serum parameters and therapy compliance were recorded;and the life quality were evaluated by Kidney Disease Quality of Life short Form（KDQOL-SFTM1.3）.The changes of Clinical parameters and life quality scores were compared before and after therapy.Results Compared with control group,the ratio of hemodialysis frequence（81.4% vs.60.47%）,diet control（79.07% vs.48.84%）,initiative consultation（100%vs.65.12%）and social activity participation（65.12%vs.25.58%）increased significantly in the therapy group,accompanied with interval water control and Kt/v improvement.The blood pressure,serum creatinine and parathyrin level decreased significantly and the hemoglobin level increased obviously at the same time（P〈0.05）.After the mental intervention,SF-36 score（64.75±10.02 vs.55.31±10.89）and Kidney Disease Targeted Areas（KDTA）score（62.62±12.26 vs.53.38±12.04）increased significantly in therapy group than in control group.The scores of physical function,role physical,emotional well-being,role emotion,symptom problem list,effects of kidney disease,works status,sexual function and sleep increased significantly in therapy group（P〈0.05）.SF-36 score and KDTA score were positively correlated with Kt/v and hemoglobin,and negatively correlated with blood pressure,serum creatinine and parathyrin.Conclusion The rational-emotive therapy can obviously improve the living quality of MHD patients by correcting negative psychoreaction and improving relative Clinical parameters.