尿毒症血液透析患者心理弹性水平及影响因素分析

Analysis of mental resilience and its influencing factors in hemodialysis patients with uremia

目的观察尿毒症血液透析患者心理弹性水平现状,并分析相关影响因素,以期为临床提供参考。方法选择2020-01-31-2023-03-31九江市中医医院进行血液透析治疗的尿毒症患者96例,调查患者基础资料、心理弹性水平。根据心理弹性水平评估结果分为良好组(n=50)和较差组(n=46),并对2组资料进行比较,分析尿毒症血液透析患者心理弹性水平的影响因素。结果96例患者经调查发现心理弹性量表(CD-RISC)评分为(59.34±8.46)分;其中心理弹性良好者有50例(52.08%)。单因素分析发现,心理弹性较差组年龄≥60岁、初中及以下学历、透析时间≥3年、消极应对、自我效能低下占比均高于心理弹性良好组,差异有统计学意义,χ^(2)值分别为11.197、9.232、10.593、9.253、9.748,P值分别0.001、0.002、0.001、0.002、0.002。Logistic回归分析显示,年龄≥60岁(β=1.429,OR=4.174,95%CI=1.647~10.580)、初中及以下学历(β=1.232,OR=3.429,95%CI=1.600~7.345)、透析时间≥3年(β=1.913,OR=6.774,95%CI=2.478~18.516)、消极应对(β=1.378,OR=3.967,95%CI=1.795~8.765)、自我效能低下(β=1.496,OR=4.462,95%CI=1.692~11.767)是尿毒症血液透析患者心理弹性水平的独立危险因素。结论尿毒症血液透析患者心理弹性水平较低,年龄≥60岁、初中及以下学历、透析时间≥3年、消极应对、自我效能低下是其独立危险因素,临床需予以高度重视。

Objective To observe the status quo of mental resilience in hemodialysis patients with uremia and analyze related influencing factors,in order to provide reference for clinical practice.Methods A total of 96 patients with uremia who underwent hemodialysis treatment in Jiujiang Hospital of Traditional Chinese Medicine from January 31,2020 to March 31,2023 were selected to investigate the basic data and psychological resilience of patients.According to the evaluation results of mental resilience level,they were divided into good group(n=50)and poor group(n=46),and the data of the two groups were compared to analyze the influencing factors of mental resilience level of uremia hemodialysis patients.Results The score of mental resilience Scale(CD-RISC)of 96 patients was 59.34±8.46.Among them,50 cases(52.08%)had good mental resilience.Univariate analysis showed that the proportion of aged≥60 years,education level of junior high school or below,dialysis time≥3 years,negative coping and low self-efficacy in the poor mental resilience group was higher than that of good mental resilience group,with statistical significant difference,χ^(2) values of 11.197,9.232,10.593,9.253,9.748,P values were 0.001,0.002,0.001,0.002,0.002.Logistic regression analysis showed that age≥60 years old(β=1.429,OR=4.174,95%CI=1.647-10.580),education level of junior high school or below(β=1.232,OR=3.429,95%CI=1.600-7.345),dialysis duration≥3 years(β=1.913,OR=6.774,95%CI=2.478-18.516),negative coping(β=1.378,OR=3.967,95%CI=1.795-8.765),low self-efficacy(β=1.496,OR=4.462,95%CI=1.692-11.767)were independent risk factors for mental resilience in hemodialysis patients with uremia.Conclusion The psychological resilience level of uremia hemodialysis patients is low,age≥60 years old,education level of junior high school or below,dialysis time≥3 years,negative coping and low self-efficacy are independent risk factors,which should be paid high attention to in clinical practice.