腹膜透析患者病耻感异质性的潜在剖面分析及预测指标研究

Potential Profile Analysis and Predictive Indicators of Disease Shame Heterogeneity in Peritoneal Dialysis Patients

目的探究腹膜透析患者疾病病耻感的潜在类别,并挖掘腹膜透析患者病耻感的预测指标。方法2024-02~04月采用方便取样法选取西安市4所三甲医院534例终末期肾脏病腹膜透析患者作为研究对象,采用一般资料调查表和疾病病耻感量表调查腹膜透析患者的病耻感状况。基于潜在剖面分析对腹膜透析患者病耻感状况进行类别分析,并采用有序多分类Logistic回归分析探索不同类别间的区分指标。结果腹膜透析患者病耻感特征可分为3种类别,分别为高病耻感组(n=235)、中病耻感组(n=219)、低病耻感组(n=80),占比分别为44.01%、41.01%,14.98%。女性(OR=3.678,P=0.027)、退休(OR=0.701,P=0.020)、无业(OR=0.556,P=0.016)是中病耻感组的预测指标;女性(OR=4.047,P=0.015)、退休(OR=0.430,P=0.037)、无业(OR=0.331,P=0.041)是高病耻感组的预测指标。结论腹膜透析患者病耻感存在明显不同的分类特征,性别、职业状态是预测中病耻感和高病耻感腹膜透析患者的预测因素。医护人员应根据患者人口学特征给予针对性的心理干预策略,尤其关注腹膜透析职业女性群体心理健康状况。

Objective To explore the potential categories and predictive indicators of disease shame in peritoneal dialysis patients.Methods A total of 534 peritoneal dialysis in the end stage renal disease patients from 4 grade A tertiary hospitals in Xi′an from February to April 2024 were selected as the research subjects by convenient sampling method,the disease shame status of peritoneal dialysis patients was investigated by general information questionnaire and disease shame scale.The disease shame status of peritoneal dialysis patients based on latent profile analysis was classified,and the distinguishing indicators between different categories were explored by ordered multiple classification Logistic regression analysis.Results The disease shame characteristics of peritoneal dialysis patients can be divided into 3 categories,including high disease shame group(n=235),medium disease shame group(n=219),and low disease shame group(n=80),accounting for 44.01%,41.01%and 14.98%,respectively.Women(OR=3.678,P=0.027),retirement(OR=0.701,P=0.020)and unemployment(OR=0.556,P=0.016)were predictive indicators of the middle disease shame group;women(OR=4.047,P=0.015),retirement(OR=0.430,P=0.037)and unemployment(OR=0.331,P=0.041)were predictive indicators of the high disease shame group.Conclusion There are significant differences in the classification characteristics of disease shame among peritoneal dialysis patients,gender and career status are predictive indicators of middle and high disease shame among peritoneal dialysis patients.Medical staff should provide targeted psychological intervention strategies based on the demographic characteristics of patients,especially paying attention to the psychological health status of occupational female groups undergoing peritoneal dialysis.