老年维持性血液透析病人心理脆弱现状及其与希望水平和社会影响的相关性

Status quo of mental vulnerability in elderly maintenance hemodialysis patients and its correlation with hope level and social impact

目的:调查老年维持性血液透析病人心理脆弱现状,并分析其与希望水平和社会影响的相关性。方法:选取2018年1月—2020年1月在我院进行维持性血液透析的117例老年病人为研究对象,采用一般资料调查表、心理脆弱量表、Herth希望量表、社会影响量表(SIS)进行调查。结果:老年维持性血液透析病人心理脆弱量表总分为(51.37±10.96)分。回归分析结果显示,女性、性格内向、对当前与未来的态度维度得分较低、积极行动维度得分较低、SIS总分较高、内在羞耻维度得分较高是老年维持性血液透析病人心理脆弱的危险因素(P<0.05)。中介效应分析结果显示,希望水平对心理脆弱的直接负向预测作用明显(β=-1.131,P<0.001),加入中介变量后,希望水平对心理脆弱的负向预测作用仍然明显(β=-0.932,P<0.001);社会影响在希望水平与心理脆弱间起中介作用(β=0.906,P<0.001),中介效应占总效应的17.61%。结论:老年维持性血液透析病人心理脆弱水平较高,医护人员应关注女性、病耻感严重、性格内向病人,提高病人希望水平并减弱病人社会影响,从而改善病人心理健康状况。

Objective:To investigate status quo of mental vulnerability in elderly maintenance hemodialysis patients,and analyze its correlation with hope level and social impact.Methods:117 elderly patients who were undergoing maintenance hemodialysis in our hospital from January 2018 to January 2020 were selected as research subjects.General information questionnaire,Mental Vulnerability Scale,Herth Hope Scale,and Social Impact Scale(SIS)were used to investigate.Results:The total score of Mental Vulnerability Scale of elderly maintenance hemodialysis patients was 51.37±10.96.The regression analysis showed that women,introversion,lower scores of current and future attitude dimensions,lower scores of positive action dimension,higher total score of SIS,and higher scores of internal shame dimension were risk factors of mental vulnerability in elderly maintenance hemodialysis patients(P<0.05).The mediating effect analysis showed that hope level had significant direct negative predictive effect on mental vulnerability(β=-1.131,P<0.001),and after adding intermediary variables,the negative predictive effect of hope level on mental vulnerability was still significant(β=-0.932,P<0.001);Social impact mediates between hope level and psychological vulnerability(β=0.906,P<0.001).Social impact had mediating effect between hope level and mental vulnerability,and the mediating effect accounted for 17.61%of total effect.Conclusions:The mental vulnerability level in elderly maintenance hemodialysis patients is relatively higher.Medical staff should pay attention to women,patients with severe sense of shame and introverted personality,improve their hope level and weaken their social influence,so as to improve their mental health.