我国血液透析中心肾脏病康复实施状况的横断面调查

A cross-sectional survey of the implementation status of renal rehabilitation in hemodialysis centers in China

目的对国内血液透析中心(hemodialysis center,HDC)进行问卷调查,评估不同经济区域、不同级别医院HDC实施肾脏病康复(renal rehabilitation,RR)的状况。方法应用RR自我评估工具(the unit self-assessment tool,USAT)评估我国不同经济区域HDC实施RR的状况。USAT总评分为100分,每个“E”分项评分20分。结果本研究共发放调查问卷225份,回收有效问卷189份,回收率为84.0%。被调查的HDC以我国公立三级综合性医院为主,大部分HDC所在医疗机构配置有康复科室(77.0%),很少有HDC配置有康复治疗间(2.1%)及康复相关的设备(12.2%)。被调查的HDC中,USAT总分≥60分的HDC比例为8.5%,总分≤20分的HDC超过20%。配置康复设备HDC的USAT总分比无相关康复设备的HDC高(Z=-3.249,P=0.001),我国不同经济区域(χ^(2)=1.129,P=0.770)、不同医院性质(综合/专科,Z=-0.118,P=0.906)、不同经营模式(公立/私立,Z=-0.063,P=0.950)、是否设立康复医学科的HDC(Z=-0.904,P=0.366)在USAT总分方面均未达到显著的统计学差异。结论我国HDC的USAT总分普遍低,RR在我国仍处于起步阶段。

Objective We conducted a questionnaire survey on the implementation status of renal disease rehabilitation(RR)in hemodialysis centers(HDCs)in the hospitals with different technical levels and located in different economical regions in China.Methods The unit self-assessment tool(USAT)was used to evaluate the implementation of RR in HDCs in hospitals.USAT has a total score of 100 points,with each"E"subscale of 20 points.Results A total of 225 questionnaires were distributed and 189 valid questionnaires were returned in this study,with a return rate of 84.0%.The surveyed HDCs were mainly public and tertiary general hospitals in China.Most of the hospitals were equipped with rehabilitation department(77.0%),but only a few of HDCs were equipped with rehabilitation treatment room(2.1%)and with rehabilitation-related equipment(12.2%).Among the HDCs surveyed,only 8.5%of the HDCs had a total USAT score of≥60,while more than 20%had a total score of≤20.HDCs with rehabilitation equipment had higher USAT scores than those without rehabilitation equipment(Z=-3.249,P=0.001).USAT scores did not achieve statistical significances in HDCs located in different economical regions(χ^(2)=1.129,P=0.770)and between general and specialty hospitals(Z=-0.118,P=0.906),public and private hospitals(Z=-0.063,P=0.950),and HDCs with and without a rehabilitation department(Z=-0.904,P=0.366).Conclusion The total USAT score is generally low in HDCs in China,and RR remains at a primary stage in China.