血液透析患者症状负担的影响因素研究

Associated factors of symptom burden among patients undergoing hemodialysis

目的调查血液透析患者的症状负担现状并分析其影响因素,为临床护理工作提供参考。方法采用方便抽样的方法选取273例血液透析患者,选用多维度症状评估量表对患者的症状负担现况进行调查。结果血液透析患者平均经历(4.43±3.12)种症状,其中疲乏、睡眠问题、瘙痒、肌肉无力和关节疼痛排序前5位。患者的症状负担总分为9.13±2.83,其中睡眠问题得分最高(10.95±4.03),其次为疲乏(10.43±4.26)和关节疼痛(10.40±4.45);腹痛症状得分最低(7.11±3.33)。多元逐步回归分析结果显示,婚姻和年龄是患者症状负担总分、症状的持续时间得分、症状的严重程度和症状给机体带来的困扰程度的预测因素,年龄还是患者症状出现频率的预测因素(调整R2=0.121、0.078、0.119、0.108、0.081,均P<0.05)。结论血液透析患者普遍经历多种不适症状,不同患者症状的发生频率、持续时间、严重程度和困扰程度不尽相同,年龄和婚姻是患者症状负担的主要预测因素。因此,全面而准确的症状评估至关重要。

Objective To investigate the symptom burden and analyze its associated factors among patients undergoing hemodialysis, and to provide reference for clinical nursing work. Methods A total of 273 patients undergoing hemodialysis were selected via conve niece sampling, and the Multidimensional Symptoms Tool was utilized to investigate patients＇ symptom burden. Results The average number of symptoms the patients experienced was 4.43±3.12, and fatigue, sleeping problems, itching, muscle weakness and joint pain were the top five symptoms. The total score of symptom burden was 9.13±2.83, and sleeping problems was scored the hig- hest （10.95±4.03）, followed by fatigue （10.43±4.26） and joint pain （10.40±4.45）, and abdominal pain was scored the lowest （7.11 ± 3.33）. Multiple step regression analysis indicated that, marital status and age were predictors of the total score of symptom burden and the scores of symptom duration, severity and distress, and age was also a predictor of symptom frequency （adjusted R2 was 0. 121,0. 028,0. 119,0. 108,0. 081 ,P〈0.05 for all）. Conclusion Patients undergoing hemodialysis generally experience multiple symptoms, and different patients experience different symptom frequency, duration, severity and distress. Age and marital status are the main predictors of symptom burden. Therefore, it is essential to assess symptom comprehensively and accurately.