维持性血液透析患者社会疏离感现状及与自我表露、社会支持的相关性分析

Investigation on the status quo of social alienation in maintenance hemodialysis patients and its correlation with self disclosure and social support

目的调查维持性血液透析(MHD)患者社会疏离感现状,并分析其与自我表露、社会支持的相关性。方法本研究为横断面调查,采用方便抽样法,选取2019年5月至2021年3月南阳市中心医院收治的156例MHD患者为研究对象,采用一般资料调查表、一般疏离感量表、痛苦表露指数量表、社会支持评定量表对研究对象进行横断面调查。结果共发放问卷176份,有效回收率为88.64%(156/176)。156例MHD患者社会疏离感得分为(41.57±4.89)分,处于中等偏上水平,与痛苦表露指数量表总分、社会支持评定量表总分呈负相关(r=-0.526、-0.284,均P<0.01);多元线性回归分析结果显示年龄、文化程度、家庭人均月收入是影响社会疏离感的主要因素(β=0.199、-0.361、-0.290,均P<0.01),将上述因素进行控制后,自我表露、社会支持独立解释MHD患者社会疏离感的变异值增加20.2%(β=-0.440、-0.200,均P<0.01)。结论MHD患者社会疏离感较高,医护人员应关注年龄大、文化程度偏低、家庭收入较少的患者,自我表露与社会支持为可干预的变量,因此医护人员可通过对患者进行自我表露训练、提高社会支持水平降低其社会疏离感,改善生命质量。

Objective To investigate the status of social alienation in maintenance hemodialysis(MHD)patients,and analyze its correlation with self disclosure and social support.Methods:From May 2019 to March 2021,156 MHD patients admitted to Nanyang Central Hospital were selected as the research objects by using convenient sampling method.A cross-sectional survey was conducted by using general information questionnaire,general alienation scale,pain disclosure index scale and social support scale.Results A total of 176 questionnaires were issued,with an effective recovery rate of 88.64%(156/176).The social alienation score of 156 patients with MHD was(41.57±4.89)points,which was at the upper-middle level and negatively correlated with the total scores of the Distress Disclosure Index and the Perceived Social Support Scale(r=-0.526,-0.284,all P<0.01).The results of multiple linear regression analysis showed that age,educational level,and per capita monthly household income were the main factors affecting social alienation(β=0.199,-0.361,-0.290,all P<0.01).After controlling for the above factors,self disclosure and social support independently explained the variance of social alienation in MHD patients increased by 20.2%(β=-0.440,-0.200,all P<0.01).Conclusions MHD patients have a high sense of social alienation.Medical staff should pay attention to patients who are older,less educated,and have low family income.Self disclosure and social support are modifiable variables,so medical staff can reduce their social alienation and improve the quality of life by training patients on self disclosure and improving the level of social support.