维持性血液透析患者二元应对现况及影响因素分析

Status Quo of Dyadic Coping in Maintenance Hemodialysis Patients and Its Influencing Factors

目的调查维持性血液透析(maintenance hemodialysis,MHD)患者二元应对现状,并分析其影响因素,为临床制订夫妻共同应对MHD治疗的干预措施提供依据。方法2021年12月至2022年12月,采用便利抽样法选取北京市3所医院血液净化病区的309例MHD患者为研究对象,采用一般资料调查表、二元应对问卷、一般自我效能感量表、血液透析患者压力源量表对其调查。结果MHD患者二元应对总分为(126.53±19.90)分,不同文化程度的MHD患者,其二元应对得分差异有统计学意义(P<0.05)。MHD患者一般自我效能平均得分为(30.01±5.44)分,压力平均得分为(42.72±17.73)分。MHD患者压力水平与一般自我效能感、二元应对呈负相关(r=-0.280,r=-0.275,均P<0.01),一般自我效能感与二元应对水平呈正相关(r=0.456,P<0.01)。文化程度、压力水平、自我效能是MHD患者二元应对的主要影响因素(均P<0.01)。结论MHD患者二元应对处于中等水平;受多因素影响,护理人员可以患者压力、自我效能为切入点,制订可行、有效的干预措施,提高其应对水平。

Objective To explore the status quo of dyadic coping in maintenance hemodialysis(MHD)patients and its influencing factors,and to provide a basis for clinical interventions for couples to cope with MHD treatment.Methods From December 2021 to December 2022,the convenience sampling method was used to select 309 MHD patients in the blood purification wards of 3 hospitals in Beijing.A survey was conducted with a general information questionnaire,Dyadic Coping Inventory(DCI),General Self-efficacy Scale(GSES),and Hemodialysis Stressor Scale(HSS).Results The total DCI score was(126.53±19.90).There were statistically significant differences in dyadic coping among MHD patients with different education levels(P<0.05).The average score of general self-efficacy of MHD patients was(30.01±5.44).The average score of stress was(42.72±17.73).The stress level of MHD patients was negatively correlated with general self-efficacy and dyadic coping(r=-0.280,r=-0.275,all P<0.01),and the general self-efficacy was positively correlated with dyadic coping(r=0.456,P<0.01).Education level,stress level and self-efficacy were the main influencing factors of dyadic coping in MHD patients(all P<0.01).Conclusion The dyadic coping in MHD patients is at an intermediate level and is influenced by multiple factors.Nurses can take patients’pressure and self-efficacy as the entry point to formulate feasible and effective intervention measures to improve their coping level.