慢性肾脏病患者自我管理类型与特点的聚类分析

Self-management types and characteristics of patients with chronic kidney disease: A cluster analysis

目的以影响慢性肾脏病(CKD)患者疾病管理行为的自我管理能力和希望水平为基础,探索CKD患者的不同类型特点。方法采用便利抽样法,选取2017 年1—6 月在陆军军医大学新桥医院肾内科慢性肾脏病管理中心随访的患者133 例为研究对象。采用慢性肾脏病患者自我管理量表和Herth希望量表对其进行测评,通过聚类分析法进行分类,比较不同类型患者的一般资料情况。结果共回收有效问卷121份。121例CKD患者可分为3种类型:Ⅰ类为高希望高自我管理能力型;Ⅱ类为高希望中自我管理能力型;Ⅲ类为中希望低自我管理能力型。3 类患者的年龄、文化程度、医疗付费方式、CKD 分期方面的差异具有统计学意义(P< 0.05)。结论本研究中CKD 患者存在3 种类型,若医护人员能有效甄别,并给予针对性个案管理措施,可更大程度地改善患者健康状况。

Objective To explore the potential types of patients with chronic kidney disease( CKD) based on their self-management ability and hope level. Methods A total of 133 patients who were selected as subjects from the follow-up cases in the Chronic Kidney Disease Management Center of Xinqiao Hospital Army Medical University from January to June 2017 using the convenient sampling method. CKD Self-Management Instrument and Herth Hope Index were used to assess the subjects and cluster analysis was used to identify patient types. Comparison of general information was conducted across different patient types. Results A total of 121 valid surveys were collected. The 121 cases of CKD patients can be characterized into 3 types: Type I patients have high self-management ability with a high hope level;Type II patients have medium selfmanagement ability with a high hope level;Type III patients have low self-management ability with a medium hope level. There were statistical differences in age, educational level, medical payment method, and CKD staging across patients of the three different types( P < 0.05). Conclusions There are 3 types of CKD patients in this study. If health professionals can effectively identify patient types and offer individualized care accordingly, the health condition of CKD patients could greatly improve.