腹膜透析患者孤独感影响因素及其与衰弱和自我管理能力的相关性研究

Study on the influencing factors of loneliness in peritoneal dialysis patients and its correlation with weakness and self-management ability

目的分析持续非卧床腹膜透析患者孤独感的影响因素,并探讨孤独感与衰弱、自我管理能力的相关性。方法采用便利抽样对2017年1月-2018年9月我院腹膜透析门诊随访的188例非卧床腹膜透析患者,应用一般资料调查表、UCLA孤独感量表、FRAIL量表及自我管理量表进行调查。结果非卧床腹膜透析患者孤独感平均得分为(41.49±8.68)分,低程度孤独感42例,中等程度孤独感108例,中高程度孤独感38例。多重线性回归分析显示,年龄(P=0.000)、居住地(P=0.012)、家庭月收入(P=0.006)、婚姻状态(P=0.000)、换液次数(P=0.000)及透析月(P=0.013)是孤独感的影响因素。FRAIL量表平均得分为(1.33±1.08)分,无衰弱者52例,衰弱前期者105例,衰弱者31例;自我管理量表平均得分为(63.16±10.01)分,处于中等水平。孤独感与衰弱呈正相关(r=0.488,P=0.000),与自我管理能力呈负相关(r=-0.829,P=0.000)。结论非卧床腹膜透析患者孤独感明显,提示临床工作中医护人员应注意评估患者孤独感,并采取相应措施减轻患者孤独感,以控制孤独感对衰弱及自我管理的影响,缓解其负面情绪,提高患者生活质量。

Objective To study the status of loneliness in patients with continuous ambulatory peritoneal dialysis and the correlation between loneliness and frailty and self-management ability.Methods 188 cases of continuous ambulatory peritoneal dialysis who were followed up in peritoneal dialysis department of the first affiliated hospital of Guangxi medical university from January 2017 to September 2018 were selected as subjects.General data questionnaire,loneliness scale of UCLA,FRAIL scale and self-management scale were used.Results The average score of loneliness in continuous ambulatory peritoneal dialysis patients was(41.49±8.68),with 42 of patients with low degree of loneliness,108 of patients with medium degree of loneliness and 38 of patients with medium high degree of loneliness.Multiple linear regression analysis showed age(P=0.000),place of residence(P=0.012),monthly household income(P=0.006),marital status(P=0.000),number of fluid changes(P=0.000),and dialysis month(P=0.013)is the influencing factor of loneliness.The mean score of FRAIL scale was(1.33±1.08),the robust patients accounted for 52,the pre-frail patients accounted for 105,and the represent frail patients accounted for 31.The self-management scale average scorewas in the middle(63.16±10.01).Loneliness was positively correlated with frailty(r=0.488,P=0.000)and negatively correlated with self-management(r=-0.829,P=0.000).Conclusion Continuous ambulatory peritoneal dialysis patients have obvious sense of loneliness.In clinical care,attention should be paid to assess the patients'sense of loneliness,and corresponding measures should be taken to alleviate the sense of loneliness so as to control the effects of loneliness on frailty and self-management.