维持性血液透析患者经济毒性现状及影响因素的研究

Research on the Current Status and Influencing Factors of Financial Toxicity in Maintenance Hemodialysis Patients

目的调查维持性血液透析(MHD)患者经济毒性现状,并分析其影响因素。方法采用一般情况调查表、经济毒性综合评分量表、心理弹性量表和社会支持评定量表对322例MHD患者进行问卷调查。结果本研究共回收有效问卷322份(91.22%),MHD患者经济毒性得分为(21.91±5.10)分,其中经济毒性得分<26分242例(75.16%);MHD患者经济毒性得分与心理弹性、社会支持总分及各维度得分均呈正相关(r>0,P<0.05);多元线性回归分析结果显示,家庭人均月收入、透析龄、心理弹性和社会支持是经济毒性的主要影响因素,可解释总变异的51.1%。结论MHD患者普遍存在高经济毒性,医护人员应注重对MHD患者经济毒性的评估,重点关注家庭人均月收入低、透析龄高的患者,提高患者心理弹性和社会支持水平,从而降低患者的经济毒性。

Objective To investigate the current status of financial toxicity in maintenance hemodialysis(MHD)patients,and to analyze its influencing factors.Methods 322 MHD patients were investigated using the general situation questionnaire,Comprehensive Scores for Financial Toxicity based on the Patient-Reported Outcome Measures,Connor-Davidson Resilience Scale and Social Support Rating Scale.Results The financial toxicity scores of MHD patients were(21.91±5.10)points,of which 242 cases(75.16%)had financial toxicity scores of less than 26 points.The scores of financial toxicity of MHD patients were positively correlated with all dimensions and the total scores of resilience and social support(P<0.05).Multiple linear regression analysis showed that the family per capita monthly income,dialysis age,total resilience score and total social support score were the main influencing factors of financial toxicity,which could explain 51.1%of the total variance.Conclusion MHD patients generally have a high level of financial toxicity.Medical staff should pay attention to the evaluation of the financial toxicity of MHD patients,focusing on patients with lower family per capita monthly income and higher dialysis age,so as to improve the resilience and social support level of patients,thereby reducing the financial toxicity of patients.