中老年维持性血液透析患者症状困扰与生命质量的调查分析

Investigation and analysis of symptom distress and quality of life in middle-aged and elderly maintenance hemodialysis patients

目的探索中老年维持性血液透析患者症状困扰、生命质量现况及相关性,分析症状困扰的影响因素。方法采用便利抽样法,使用一般人口学问卷、血液透析患者症状困扰量表、12条目简短生命质量量表对160例中老年维持性血液透析患者进行问卷调查。结果中老年维持性血液透析患者排名最高的前10名症状的发生率为71.88%~55.63%;生命质量总体得分(37.4±6.8)分、生理健康层面(40.3±6.3)分、心理健康层面(34.6±6.0)分均低于国内常模(t值分别为-34.686、22.060、-30.430,P均<0.001);症状困扰程度与生命质量呈负相关(r=-0.511,P<0.001);多元回归显示年龄、居住地、收入、患病数量是症状困扰的影响因素(β值分别为1.819、-2.606、-2.128、2.055,P值分别为0.009、0.021、0.003、0.006)。结论中老年维持性血液透析患者普遍经历多种不适症状,生命质量偏低,不同人口学特征及患病情况等差异,症状困扰程度不同,应根据患者具体情况制定个性化护理措施,减轻患者症状负担,提高生命质量。

Objective To explore the status and the correlation of symptom distress and quality of life in middle-aged and elderly maintenance hemodialysis(MHD)patients,and to analyze the influencing factors for symptom distress.Methods A total of 160 MHD patients were recruited by convenience sampling method.The investigation included general information questionnaire,dialysis symptom index and the 12-item short from health survey.Results The overall quality of life score was 37.4±6.8 points,among which physiological health score was 40.3±6.3 points and mental health score was 34.6±6.0 points,all lower than the domestic norm.(t=-34.686,22.06 and-30.43 respectively,P<0.001).Symptom distress was negatively correlated with quality of life(r=-0.511,P<0.001).Multiple regression showed that age,residence place,income and number of diseases were the influencing factors for symptom distress(β=1.819,-2.606,-2.128 and 2.055 respectively;P=0.009,0.021,0.003 and 0.006 respectively).Conclusion The middle-aged and elderly MHD patients generally experience a variety of uncomfortable symptoms,and their quality of life is relatively low.Different demographic characteristics and disease conditions lead to different levels of symptom distress.Medical staff should design individualized nursing measures according to the specific conditions of the patients to reduce the symptom burden and improve the quality of life of the patients.