维持性血液透析患者社会隔离现状及影响因素分析

Analysis of the current situation and factors influencing social isolation of maintenance hemodialysis patients

目的:调查维持性血液透析患者社会隔离发生现状并分析其影响因素,为实施针对性的干预措施提供理论依据。方法:本研究为横断面研究,便利选取2021年10月至2022年3月新疆3所血液净化中心315例透析患者为研究对象,采用一般资料问卷、Lubben社会网络量表-6、国际体力活动问卷(久坐行为部分)、病人健康问卷-9、Frail量表对其进行调查。采用单因素分析和二元Logistic回归分析探讨影响透析患者社会隔离的影响因素。结果:28.89%(91/315)的维持性血液透析患者存在社会隔离,二元Logistic回归分析显示,年龄(45~59岁:OR=4.815,95%CI 1.362~17.017;≥60岁:OR=8.968,95%CI 2.349~34.236)、透析龄(OR=2.788,95%CI 1.334~5.826)、久坐行为(OR=2.504,95%CI 1.406~4.461)、抑郁状态(OR=2.095,95%CI 1.179~3.722)、衰弱状态(OR=2.043,95%CI 1.062~3.933)是维持性血液透析患者社会隔离的影响因素(均P<0.05)。结论:维持性血液透析患者社会隔离发生与高龄、高透析龄、久坐行为、衰弱及抑郁状态密切相关,提示血液净化中心医务人员可根据相关影响因素有针对性的实施干预,以预防或改善患者社会隔离水平。

Objective To investigate the current situation of occurrence of social isolation in maintenance hemodialysis patients and analyze its influencing factors,in order to provide a theoretical basis for the implementation of targeted interventions.MethodsThe study was a cross-sectional study.A total of 315 dialysis patients in three hemodialysis centers in Xinjiang were selected by simple sampling method from October 2021 to March 2022,who were investigated using the general information questionnaire,Lubben-6 social network scale,International Physical Activity Questionnaire(sedentary behavior section),Patient Health Questionnaire 9-item scale(PHQ-9)and Frail Scale.Univariate analysis and binary Logistic regression analysis were used to explore the influencing factors affecting the social isolation of dialysis patients.ResultsSocial isolation was present in 28.89%(91/315)of maintenance hemodialysis patients,and binary Logistic regression analysis revealed that age(45-59 years old:OR=4.815,95%CI 1.362-17.017;≥60 years old:OR=8.968,95%CI 2.349-34.236),dialysis age(OR=2.788,95%CI 1.334-5.826),sedentary behavior(OR=2.504,95%CI 1.406-4.461),depression(OR=2.095,95%CI 1.179-3.722),and debilitation(OR=2.043,95%CI=1.062-3.933)were influencing factors of social isolation in maintenance hemodialysis patients(all P<0.05).ConclusionsThe occurrence of social isolation in maintenance hemodialysis patients was closely associated with advanced age,high dialysis age,sedentary behavior,debilitation,and depressive status,suggesting that medical staff in hemodialysis centers can implement targeted interventions to prevent or improve the level of social isolation in patients based on relevant influencing factors.