血液透析患者透析相关知识知晓情况及其影响因素分析

The awareness of dialysis related knowledge and its influence factors in hemodialysis patients

目的了解维持性血液透析(maintenance hemodialysis,MHD)患者透析相关知识知晓现状并探讨其影响因素。方法选择广东省中医院大学城医院血液透析中心MHD患者104例进行横断面调查,采用自制的透析相关知识问卷评估患者的透析相关知识知晓情况并分析其影响因素。结果MHD患者透析相关知识总分为(56.41±10.09)分,掌握良好者占1.9%,中等33.7%,较差64.4%。年龄是MHD患者高钾血症、钙磷紊乱、饮食原则等知识得分的影响因素(β值分别为-0.226、-0.341、-0.216,P值分别为0.025、<0.001、0.023),教育程度是容量控制、肾性贫血、饮食原则等知识得分的影响因素(β值分别为0.209、0.230、0.187,P值分别为0.039、0.023、0.045),透析方案是钙磷紊乱、饮食原则等知识得分的影响因素(β值分别为0.235、0.254,P值分别为0.013、0.010),责任护士专科工作年限是肾性贫血、饮食原则、血管通路等知识得分的影响因素(β值分别为0.256、0.316、0.284,P值分别为0.040、0.008、0.025)。结论MHD患者对透析相关知识的知晓情况不容乐观,教育者应关注年龄大、教育程度低、透析方案单一的患者,对其加强健康教育;管理者应对血液透析专科工作年限低的护士加强培训,提高其健康教育的能力。

Objective To investigate the awareness of dialysis related knowledge and its influence factors in maintenance hemodialysis (MHD) patients. Methods A cross-sectional survey was conducted in 104 MHD patients treated in the Hemodialysis Center, University Town Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine. Self-made dialysis related knowledge questionnaire was used to assess the awareness of dialysis related knowledge and its influence factors. Results The total score of dialysis related knowledge was 56.41+10.09 in the MHD patients. The percentages of the MHD patients with good, moderate and low levels of the knowledge were 1.9%, 33.7% and 64.4% respectively. Age was the influence factor for the knowledge scores of hyperkalemia, calcium and phosphorus disorders, and dietary principle (β=-0.226,-0.341 and -0.216 respectively;P=0.025, 0.000 and 0.023 respectively). Education level was the influence factor for the knowledge scores of volume control, renal anemia and dietary principle (β=0.209, 0.230 and 0.187 respectively;P=0.039, 0.023 and 0.045 respectively). Dialysis protocol was the influence factor for the knowledge scores of calcium and phosphorus disorders and dietary principle (β=0.235 and 0.254 respectively;P=0.013 and 0.010 respectively). The service year of the responsible nurses was the influence factor for the knowledge scores of renal anemia, dietary principle and vascular access (β=0.256, 0.316 and 0.284 respectively;P=0.040, 0.008 and 0.025 respectively). Conclusion The awareness of dialysis related knowledge in MHD patients is insufficient. Medical staff should focus the education about the dialysis related knowledge on the patients with older age, lower education level and a single dialysis protocol. Administrators of hemodialysis should enhance the training especially for nurses with lower service years, through which their health education ability can then be improved.