维持性血液透析患者营养素养现状及其影响因素分析

Nutritional literacy status and influencing factors of maintenance hemodialysis patients

目的 调查维持性血液透析(maintenance hemodialysis, MHD)患者营养素养的现状,并分析其影响因素,为制定营养素养干预方案提供参考依据。方法 采用便利抽样法选取2023年10月至12月在邵阳市区3家三级甲等医院血液净化中心行MHD的患者。采用一般人口学资料调查表、MHD患者营养素养测评问卷、医院焦虑抑郁量表、社会支持评定量表、慢性病自我效能量表、GLIM营养不良诊断标准进行调查,分析MHD患者营养素养的现状及影响因素。结果 共纳入555名MHD患者,营养素养平均得分为92.823±13.643分,5个维度中营养态度得分为3.814±0.681,营养知识平均分为3.783±0.647,营养技能平均分为3.647±0.682,信息互动平均分为3.596±0.773,信息评判得分为3.630±0.691。多元线性回归分析结果显示居住地、文化程度、个人月收入、焦虑、抑郁、社会支持、自我效能是MHD患者营养素养的主要影响因素(P<0.05)。结论 MHD患者营养素养处于中等水平,需要重点关注来自农村、文化程度低、月收入低和患有焦虑抑郁的MHD患者,鼓励医护、病友和家人多支持和互动,提高其自我效能,不断提升其营养素养水平。

Objective To investigate the current status of nutritional literacy among maintenance hemodialysis(MHD)patients and analyse the factors affecting it,so as to provide a reference basis for the development of a nutritional literacy intervention programme.Methods Convenience sampling was used to select patients who underwent MHD from October to December 2023 at the haemodialysis centres of 3 tertiary-level hospitals in Shaoyang city district.A general information questionnaire,nutritional literacy assessment questionnaire for maintenance haemodialysis patients,medical anxiety and depression scale,social support scale,chronic disease self-efficacy scale,and GLIM malnutrition assessment scale were used to investigate and analyse the current situation of nutritional literacy in MHD patients and the influencing factors.Results A total of 555 MHD patients were included,with a nutritional literacy mean score of 92.823±13.643,a mean score of 3.814±0.681 for nutritional attitudes,3.783±0.647 for nutritional knowledges,3.647±0.682 for nutritional skills,3.596±0.773 for information interaction,and 3.630±0.691 for information evaluation.The results of multiple linear regression analyses showed that place of residence,education level,personal monthly income,anxiety,depression,social support,and self-efficacy were the main influences on nutritional literacy of MHD patients(P<0.05).Conclusion Nutritional literacy of MHD patients is at a moderate level,and it is necessary to focus on MHD patients who are rural,with low education level,low monthly income,and suffer from anxiety and depression,and to encourage healthcare professionals,wardmate,and family members to provide more support and interactions,to improve their self-efficacy,and to continually improve their level of nutritional literacy.