肾移植前后维持性血液透析患者情绪对饮水控制依从性的影响(英文)  

Effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation

作　　者：侯永梅[1] 胡佩诚[2] 梁燕萍[3] 莫湛宇[3] 

机构地区：[1]广东医学院心理学教研室,广东省湛江市524023 [2]北京大学医学部医学心理学教研室,北京市100083 [3]广东医学院附属医院肾内科,广东省湛江市524001

出　　处：《中国组织工程研究与临床康复》2010年第31期5869-5872,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：the Tackle Key Program of Science and Technology of Zhanjiang City in 2006~~

摘　　要：背景: 维持性血液透析患者普遍存在着饮水控制依从困难的问题,影响病情的转归,心理问题对饮水控制依从性有着重大的影响。目的:分析合理情绪疗法对维持性血液透析患者饮水控制依从性的影响。方法:将维持性血液透析患者 100 例随机分为干预组和对照组,每组 50 例。对照组接受常规的血液透析治疗;干预组在此基础上,接受为期 3 个月的合理情绪治疗。干预前和干预后分别用医学应对问卷和症状自评量表对两组患者进行评定;分别在干预前和干预结束时连续 3 次测定与饮水控制依从性相关的临床指标,求每项指标的平均值。结果与结论:共 92 例患者(干预组 48 例,对照组 44 例) 完成研究。干预后,干预组患者在医学应对问卷的面对和回避两大分量表得分显著高于对照组,屈服分量表的得分、症状自评量表问卷的总均分及躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖和附加因子的得分、4 项与饮水控制依从性相关的临床指标(透析间期体质量的平均增加量与干体质量的比值、透析前的平均收缩压、透析前的平均舒张压、平均超滤量)均显著低于对照组(P < 0.05)。提示合理情绪疗法能增强患者的应对能力,改善其心理健康水平,提高其饮水控制依从性。BACKGROUND： Non-adherence to fluid restrictions is common in patients maintained on hemodialysis prior to and after kidney transplantation, which has a profound influence on the development and transfer of illness of the patients. Mental factors have great influences on adherence to fluid restrictions. OBJECTIVE： To investigate the effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation. METHODS： In total 100 patients maintained on hemodialysis were randomly assigned to an intervention group （n = 50） and a control group （n = 50）. The control group received the conventional therapy. At the same time, the intervention group received the conventional therapy combined with rational-emotive therapy. All cases were assessed with the Symptom Checklist 90 （SCL-90） and Medical Coping Modes Questionnaire （MCMQ） prior to and after intervention. Clinical indices related to adherence to fluid restrictions were measured three successive times and the average score of each index was calculated. RESULTS AND CONCLUSION： Forty-eight patients from the intervention group and 44 patients from the control group accomplished the study. After intervention, the scores of the two subscales, confronce and avoidance, were significantly higher than those in the control group （P 0.05）. However, some scores were significantly lower than those in the control group, including the score of acceptance/resignation subscale of MCMQ, total average score of SCL-90, the score of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, photic anxiety and additional items, and the score of four clinical indices related to adherence to fluid restrictions （the ratio of interdialysis weight gain to dry weight, mean systolic blood pressure, mean diastolic blood pressure, and mean ultrafiltration volume prior to hemodialysis） （P 0.05）. All these findings suggest that rational-emotive therapy

关 键 词：肾移植 维持性血液透析 合理情绪疗法 应对 心理健康 饮水控制依从性 随机对照研究 

分 类 号：R617[医药卫生—外科学]