围透析期慢性肾脏病患者夫妻疾病感知与希望水平的关系研究

Relationship between couples'illness perception and hope level of peridialysis patients with chronic kidney diseases

目的探讨围透析期慢性肾脏病患者夫妻疾病感知对希望水平的影响,为后期临床开展以夫妻为中心的二元干预提供理论支持及依据。方法纳入郑州大学第一附属医院肾病内科的140对围透析期慢性肾脏病患者夫妻为研究对象,采用简易疾病感知问卷和中文版希望量表进行调查研究。通过主客体互倚模型,分析围透析期慢性肾脏病患者夫妻疾病感知对希望水平的影响。结果围透析期慢性肾脏病患者夫妻希望水平处于中等水平,患者希望量表总分及各维度评分均低于配偶,简易疾病感知问卷总分及认知、情绪维度评分均高于配偶(P<0.05或0.01)。围透析期慢性肾脏病患者夫妻的疾病感知和希望水平存在相关性(P<0.01)。主体效应方面,围透析期慢性肾脏病患者夫妻的疾病感知都会对其希望水平产生影响(P<0.01);客体效应方面,围透析期慢性肾脏病患者的疾病感知都会对其配偶的希望水平产生影响(P<0.05)。结论围透析期慢性肾脏病患者夫妻的希望水平受自身和对方疾病感知的交互影响。医护人员应将围透析期慢性肾脏病患者夫妻视为一个共同体,有助于实施以夫妻为中心的相互支持应对策略,从而提高他们应对围透析期时的希望水平。

Objective To explore the effects of couples'illness perception of peridialysis patients with chronic kidney diseases(CKD)on hope levels to provide theoretical support and basis for couplecentered dual intervention clinically.Methods A total of 140 couples of peridialysis CKD patients from nephrology department of the First Affiliated Hospital of Zhengzhou University were included into study subjects and investigated using the Brief Illness Perception Questionnaire(Brief-IPQ)and the Chinese version of Herth Hope Index(HHI).The effects of couples'illness perception on hope level were analyzed using the actor-partner interdependence model(APIM).Results Couples'hope level of peridialysis CKD patients was moderate,the total and each dimension score of the HHI were lower and the total,cognition,and emotion of the Brief-IPQ higher in patients than spouses(P<0.05 or 0.01).Couples'illness perception of peridialysis CKD patients was correlated with hope levels(P<0.01).In the aspect of actor effect,illness perceptions of both husband and wife had an influence on hope levels(P<0.01);in the aspect of partner effect,patients'illness perception had an influence on spouse's hope levels(P<0.05).Conclusion Couples'hope levels of peridialysis CKD patients are inf luenced by the interaction between their own and spouses'illness perception.The couples of peridialysis CKD patients should be treated as a community by medical staff,which helps to implement couple-centered mutuallysupportive coping strategies so as to improve their hope levels in coping with peridialysis.