血液透析患者电子健康素养与透析充分性的相关性研究

Study on the Correlation Between E-Health Literacy and Adequacy of Dialysis in Maintenance Hemodialysis Patients

目的 了解三甲医院维持性血液透析(maintenance hemodialysis,MHD)患者电子健康及透析充分性水平,探讨两者之间的相关性。方法 选取2023年1—6月福建省泉州市第一医院城东院区153例MHD患者。应用自制一般资料调查表、电子健康素养量表(e-Health literacy scale,eHEALS)及透析充分性指标尿素清除分数(single pool clearance index,spKt/V)和尿素下降率(urea reduction ratio,URR)进行调查,当场发放填写当场收回,采用单因素方差分析及t检验等方式研究MHD患者电子健康素养与透析充分性的相关性。结果 MHD患者透析充分性指标SpKt/V为(1.42±0.38),URR为(69.41±8.83)%;e HEALS平均得分较低,为(20.52±12.33)分。性别、年龄、经济收入、文化程度、工作情况、医保情况、查询信息的频率、spKt/V对MHD患者电子健康素养的影响差异有统计学意义(P<0.05),性别、文化程度对MHD患者的透析充分性指标spKt/V及URR的影响差异有统计学意义(P<0.05),电子健康素养在spKt/V达目标值中差异有统计学意义(P<0.05)。在充分性评估中,spKt/V与URR存在相关性(P<0.05)。结论 MHD患者电子健康素养得分相对较低,透析充分性基本可达最低目标值。MHD患者电子健康素养水平与透析充分性无显著的相关性,但血液透析室医务人员就低电子健康素养水平现状制定相应的干预措施,重视MHD患者对网络卫生资源的利用能力,因此提高MHD的自我健康问题管理能力和透析充分性,改善其生活质量。

Objective To understand the level of e-Health and dialysis adequacy of patients with maintenance hemodialysis(MHD)in top three hospitals,and to explore the correlation between them.Methods A total of 153 MHD patients from January to June 2023 were selected from Quanzhou First Hospital(Chengdong),Fujian.The survey was conducted using self-made general data questionnaire,e-Health literacy scale(eHEALS),dialysis adequacy index single pool clearance index(spKt/V)and urea reduction ratio(URR),which were distributed on the spot,filled in and collected on the spot.The correlation between e-Health literacy and dialysis adequacy in MHD patients was studied by one-way ANOVA and t test.Results The dialysis adequacy index SpKt/V and URR were(1.42±0.38)and(69.41±8.83)%respectively in MHD patients.The eHEALS have lower average scores,average score of eHEALS was(20.52±12.33)points.Gender,age,economic income,educational level,working condition,medical insurance condition,frequency of information query and spKt/V had significant differences on e-Health literacy of MHD patients(P<0.05).There were significant differences in gender and education on dialysis adequacy index spKt/V and URR in MHD patients(P<0.05).The difference of e-Health literacy in spKt/V reaching target value was statistically significant(P<0.05).In the adequacy assessment,spKt/V was correlated with URR(P<0.05).Conclusion The electronic health literacy scores of MHD patients are relatively low,while the overall adequacy of dialysis can generally reach the minimum target value.There was no significant correlation between the level of e-Health literacy and dialysis adequacy in MHD patients.The medical staff in the hemodialysis room immediately formulated corresponding intervention measures for this issue,attaching importance to the ability of MHD patients to use online health resources.Therefore,it improves the self-management ability of MHD patients'health issues and dialysis adequacy,and improves their quality of life.