影响腹膜透析患者依从性因素的调查与分析

Investigation and analysis of the factors influencing the compliance in peritoneal dialysis patients

目的了解腹膜透析患者依从性的现状及其影响因素，探讨提高患者依从性的对策。方法以2012年2月～2013年10月，在我院肾内科住院治疗和规律门诊随访的89例腹膜透析患者为调查对象，采用自行设计的问卷，通过随访调查其依从性及影响因素。结果腹膜透析透析龄大于12个月的患者，按期复诊人数（x^2=4．352，P：0．045），遵医嘱用药（x^2=7．290，P=0．007），日常生活自我管理能力（x^2=6．977，P=0．008），社会、家庭支持情况（x^2=4．903，P=0．032），并发症的发生（x^2=3．817，P=0．049）等依从性要优于透析龄小于等于12个月的患者，其差异有统计学意义（P〈0．05）；不同年龄患者比较，大于等于65岁而小于等于75岁患者依从性更好，差异有统计学意义（x^2=3．470，P=0．028）；经济收入低的患者治疗依从性差，差异也具有统计学意义（x^2=4．971，P=0．046）。结论不同透析龄和不同年龄的腹膜透析患者的依从性存在差异，临床上应采取不同的应对措施，因需施护，进一步提高腹膜透析患者的依从性、延缓疾病的讲孱。

Objective By understanding the current situation and influencing factors for compliance in peritoneal dialysis （PD） patients, so as to develop strategies to improve their compliance. Method A total of 89 PD patients treated in our hospital between Feb. 2012 and Oct. 2013 were enrolled in this study. The compliance and its influencing factors were investigated by self-designed questionnaire. Result The compliance of scheduled visiting, prescribed medication, self management ability of daily life, social and family support, presence of complications were better in PD patients with dialysis age 〉 12 months than in those with dialysis age 〈12 months （for scheduled visiting： x^2=4.352, P=-0.045; for prescribed medication： x^2=7.290, P=0.007; for self management ability of daily life：x^2=6.977, P=-0.008; for social and family support： x^2=4.903, P=-0.032; for presence of complications： x^2=3.817, P=-0.049）. The compliance was better in PD patients of 〉65 years old and 〈75 years old （x^2=3.470, P=0.028）, and worse in PD patients with lower income （x^2=4.971, P=0.046）. Conclusion The compliance was different in PD patient with different age and dialysis vintage. Correspond- ing measures should be carried out to improve their compliance and to postpone the progress of their disease course.