终末期肾病患者透析早期阶段应对方式的影响因素分析

Influencing factors of coping style at early stage of dialysis in patients with end-stage renal disease

目的探讨终末期肾病(ESRD)患者透析早期阶段(1年内)的应对方式和影响因素。方法从本地4所医院中抽取2018年4月—2019年9月正在接受腹膜透析或者血液透析治疗的250例ESRD患者作为研究对象。调查过程中主要涉及常规资料问卷、医学应对问卷、领悟社会支持量表、中文版事件相关反刍性沉思问卷等调查工具。结果ESRD患者透析早期阶段的面对评分19.11±3.29分,回避评分15.33±2.57分、屈服评分11.36±3.23分。单因素分析显示,年龄、经济情况、学历水平、家庭照护者、透析时间、自觉疾病了解程度、反刍性沉思水平、社会支持水平是影响透析不超过1年ESRD患者应对方式的相关因素(P<0.05);多元逐步回归分析显示,患者应对方式受家庭照护者、经济状况、自觉疾病了解程度、反刍性沉思、社会支持水平等因素影响(P<0.05)。结论ESRD患者透析早期阶段,更愿意选择面对这一积极应对方式,作为护理人员,要加强疾病与透析相关知识的针对性教育,引导家属予以有力的家庭支持,从而增强患者面对疾病的信心与积极性。

Objective To investigate the coping styles and influencing factors of patients with end-stage renal disease(ESRD)at the early stage of dialysis(within 1 year).Methods A total of 250 ESRD patients recieved peritoneal dialysis or hemodialysis treatment from April 2018 to September 2019 in 4 local hospitals were selected as the study subjects.The survey mainly involved the general information questionnaire,the medical coping questionnaire,the perceptive social support scale,the Chinese version of the event related ruminant meditation questionnaire and other survey tools.Results Facing score of ESRD patients at early stage of dialysis was 19.11±3.29 point,avoidance score was 15.33±2.57 point,and yield score was 11.36±3.23 point.Univariate analysis showed that,age,economic status,education level,home caregivers,dialysis time,self-auareness level of disease,rumination meditation level,social support level were the related factors that effect the ESRD patients'(within 1 year)coping style(P<0.05).Multivariate stepwise regression analysis showed that,the coping style of patients was affected by family caregivers,economic status,self-awareness level of the disease,rumination meditation,social support level(P<0.05).Conclusion At the early stage of dialysis,ESRD patients were more willing to take this positive coping mode.The nursing staffs should strengthen the targeted education of disease and dialysis related knowledge,guide the family members to give powerful family support so as to enhance the patients'confidence and enthusiasm when facing of the disease.