终末期肾病患者透析早期阶段的应对方式及其影响因素  

Influencing Factors and Coping Style of End-stage Renal Disease Patients in the Early Stage of Dialysis

作　　者：胡琛[1] 潘凌蕴[2] 刘晓虹[1] 

机构地区：[1]第二军医大学护理学院,上海200433 [2]南京军区总医院国家肾脏疾病临床医学研究中心,江苏南京210002

出　　处：《解放军护理杂志》2016年第8期22-26,30,共6页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的调查终末期肾病患者透析早期阶段(1年内)的应对方式,并探讨其影响因素。方法 2013年6月至2014年11月采用便利抽样法选取上海、南京、海宁等地6所医院正在接受透析治疗的患者250例,采用一般资料问卷、直观式健康量表(European quality of life-visual analogue scale,EQ-VAS)、中文版事件相关反刍性沉思问卷、领悟社会支持量表、医学应对量表进行调查。结果终末期肾病患者透析早期阶段的面对得分[(19.10±3.28)分]与常模无统计学差异(P>0.05),回避[(15.32±2.56)分]、屈服[(11.35±3.02)分]得分明显高于常模(均P<0.05)。其中面对维度得分与其自觉对疾病的了解程度和家庭支持有关;回避维度得分与目的性反刍性沉思有关;屈服维度得分的影响因素包括患者对健康状况的自我评价、自觉痛苦程度、有无工作、对疾病了解程度、朋友支持以及侵入性反刍性沉思。结论终末期肾病患者透析早期阶段更倾向于采取面对的积极应对方式,护士应通过加强疾病和透析知识教育、鼓励家庭支持的方式帮助患者积极面对疾病;对于回避的应对方式应结合具体情况加以分析;对于屈服这一消极应对方式应及时甄别,并通过知识宣教、鼓励人际交往、减少侵入性反刍性深思等方法帮助患者积极面对疾病。Objective To analyze the coping style of end-stage renal disease patients in the early stage of dialysis（within 1year）and its influencing factors.Methods By convenience sampling,250 cases were selected and evaluated by self-designed general questionnaire,European Quality Of Life-visual Analogue Scale（EQ-VAS）,Chinese Event Related Rumination Inventory（C-ERRI）,Perceived Social Support Scale（PSSS）and Medical Coping Mode Questionnaire（MCMQ）.Results There was no statistically significant difference between the patients and norm in＂confrontation＂score（19.10±3.28）（P〈0.05）while the＂avoidance＂（15.32±2.56）and＂resignation＂score（11.35±3.02）of the patients were significantly higher than norm（all P〈0.05）.The score on＂confrontation＂was related with the knowledge about the disease and family＇s support;the score on＂avoidance＂was related with the patient＇s deliberate rumination;the score on ＂resignation＂was related with the VAS score.tThe self-evaluation of health status,the degree of suffering,the work status,the knowledge about the disease,friends＇ support and intrusive rumination were the influencing factors.Conclusions The patients in the early stage of dialysis are easier to take the active coping style.The dialysis nurses should perform health education and encourage the family support to help the patients to take the strategy of confrontation.The avoidance action of the patients should be analyzed combining with the specific situation.The nurses should identify the patients who are easy to use the resignation strategy and perform health education to them,encourage the interpersonal communication,as well as cut down intrusive rumination.

关 键 词：终末期肾病 透析 早期 应对方式 影响因素 

分 类 号：R692[医药卫生—泌尿科学]