中青年血液透析患者重返工作准备度现状及影响因素分析

Current status and influencing factors of readiness for young and middle-aged hemodialysis patients to return to work

目的调查中青年维持性血液透析患者重返工作准备度现状,并分析其影响因素,旨在为患者重返工作的评估与干预提供参考。方法采用便利抽样法,于2022年10—12月,选取扬州城区6所医院的425例患者为研究对象。采用一般资料调查表、重返工作准备度量表、痛苦表露指数量表和领悟社会支持评定量表进行横断面调查,使用二分类Logistic回归分析重返工作的影响因素。结果425例中青年维持性血液透析患者中重返工作者105例(24.7%),其中处于不确定维持阶段79例(75.2%)、主动维持阶段26例(24.8%);未重返工作者320例,其中处于前意向阶段148例(46.3%)、意向阶段86例(26.9%)、行动准备-自我评估阶段42例(13.1%)、行动准备-行为阶段44例(13.8%)。年龄、家庭人均月收入、合并症数量、自我表露水平、领悟社会支持水平是影响患者重返工作准备度的因素。结论中青年维持性血液透析患者重返工作率有待提高。患者选择是否重返工作受多种因素影响,医护人员应重点关注年龄大、家庭人均月收入低、合并症数量多的患者,同时对患者进行自我表露训练、提高领悟社会支持水平等针对性干预和指导,以提高患者重返工作率。

Objective To explore the current status of readiness for young and middle-aged maintenance hemodialysis(MHD)patients to return to work and analyze its influencing factors,with the aim of providing reference for the evaluation and intervention of patients returning to work.Methods From October to December 2022,convenience sampling was used to select 425 patients from six hospitals in the urban area of Yangzhou as the subject.A cross-sectional survey was conducted using the General Information Questionnaire,Readiness for Return-To-Work Scale(RRTWS),Distress Disclosure Index(DDI)and Perceived Social Support Scale(PSSS).Binary Logistic regression was used to analyze the influencing factors of returning to work.Results Among 425 young and middle-aged patients undergoing MHD,105(24.7%)returned to work,of which 79(75.2%)were in the uncertain maintenance stage and 26(24.8%)were in the active maintenance stage.320 did not return to work,including 148(46.3%)in the pre-intention stage,86(26.9%)in the intention stage,42(13.1%)in the action preparation self-evaluation stage,and 44(13.8%)in the action preparation behavior stage.Age,per capita monthly income of the family,number of comorbidities,level of self-disclosure,and level of perceived social support were factors that affected patients'readiness to return to work.Conclusions The rate of young and middle-aged MHD patients returning to work needs to be improved.The return of patients to work is influenced by multiple factors.Medical and nursing staff should focus on patients who are old,have low per capita monthly income of the family,and have a large number of comorbidities.Targeted interventions and guidance should be provided to patients,such as self-disclosure training and improving their perceived social support,in order to increase the rate of patients returning to work rate.