长期血液透析患者的焦虑现状、影响因素及其与生活质量的相关性

Survey on the status and influencing factors of anxiety among maintenance hemodialysis patients and the relationship between anxiety and quality of life

目的调查长期血液透析(MHD)患者的焦虑发生情况,分析其影响因素,并探讨焦虑与生活质量的相关性。方法于2016年1月至2017年12月随机抽取住院号或门诊号为单号于宜宾市第二人民医院肾内科透析室长期血液透析患者210例,采用焦虑自评问卷(SAS)和肾脏疾病特异性调查表(KDQ)评价患者的焦虑发生情况和生活质量,采用自行设计问卷表分析患者焦虑的影响因素,并用列联表χ2检验分析焦虑与生活质量的相关性。结果 210例MHD患者发生焦虑91例,发生率为43.3%;KDQ评分为(139.3±29.6)分,<50岁组、50～65岁组和>65岁组KDQ评分分别为(142.8±26.9)分、(139.6±25.3)分和(136.3±23.1)分,组间比较差异有统计学意义(P<0.05);单因素分析结果显示,医疗保险、婚姻状况、家庭月收入、透析龄、并发症、营养风险、社会支持度和性别都是焦虑的可能影响因素(P<0.05);多因素Logistic回归分析结果显示,医疗保险、性别、家庭月收入、透析龄、营养风险及社会支持度是影响患者焦虑的重要因素(OR分别为0.256、0.384、0.396、2.327、7.456和0.385,P<0.05);列联表χ2检验显示:患者焦虑与生活质量有相关性(列联系数c=0.335,P<0.05)。结论长期血液透析患者焦虑发生率高,经济原因、透析时长、营养风险和社会支持度是焦虑发生的影响因素,焦虑也影响患者生活质量,有必要加强患者指导,营造良好的社会支持外部环境,促进患者身心健康。

Objective To investigate the status and influencing factors of anxiety among patients undergoing maintenance hemodialysis(MHD),and discuss the relationship between anxiety and quality of life(QOL).Methods From January 2016 to December 2017,210 MHD patients were selected randomly from No.2 People’s Hospital of Yibin to investigate the status of anxiety and quality of life by self-ranking anxiety scale(SAS)and kidney disease questionnaire(KDQ),and to analyze the influencing factors of anxiety by self-designed questionnaire.Results The incidence of anxiety was 43.3%(91/210)among 210 MHD patients.The KDQ score was 139.3±29.6 with age difference,and KDQ score of patients with<50,50 to 65 and>65 years old were 142.8±26.9,139.6±25.3,and 136.3±23.1,respectively(P<0.05).Univariate analysis showed that medical insurance,marriage,family month income,duration of hemodialysis,complications,nutritional risk,social support and gender were possible factors of anxiety(P<0.05).Multiple logistic regression showed that medical insurance,gender,family month income,duration of hemodialysis,nutritional risk,and social support were the influencing factors of anxiety(OR=0.256,0.384,0.396,2.327,7.456,and 0.385,respectively,P<0.05).Contingency table Chi-square test showed that the relevance between anxiety and quality of life was observed(coefficient of contingency c=0.335,P<0.05).Conclusion The incidence of anxiety is high among MHD patients,and economic reasons,duration of hemodialysis,nutritional risk,and social support are influencing factors of anxiety.Anxiety also affects QOL of patients.It is essential to strengthen patients’guideline and build a good external social support environment to promote physical and mental health of MHD patients.