慢性肾脏病1～3期患者希望水平对自我效能及自我管理的影响效应  

Effect of Hope on Self-efficacy and Self-management in Patients with Chronic Kidney Disease(Stages 1-3)

作　　者：刘彤[1] 陈丹虹 贾群妹 赵杉 左玲燕[1] 黄宝延[2] 陈丽萌[1] LIU Tong;CHEN Danhong;JIA Qunmei;ZHAO Shan;ZUO Lingyan;HUANG Baoyan;CHEN Limeng(Department of Nephrology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;School of Nursing,CAMS and PUMC,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院肾内科,北京100730 [2]中国医学科学院北京协和医学院护理学院,北京100144

出　　处：《中国医学科学院学报》2019年第3期367-372,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的了解慢性肾脏病(CKD)1~3期患者希望水平、自我效能及自我管理的现状,探讨3个变量之间的相互影响效应。方法应用Herth希望量表、美国Stanford大学慢性病管理自我效能量表、早期慢性肾脏病患者自我管理量表对北京协和医院153例CKD(1~3期)住院患者进行调查,采用结构方程建模法建立患者希望水平、自我效能及自我管理的结构方程模型。结果患者希望水平总体中位得分为40.0(36.0,44.5)分,85.0%患者处于高等希望水平;中位总体自我效能得分为8.3(7.1,9.4)分;自我管理总体得分为(89.0±13.4)分。不同年龄段、性别、婚姻状况、文化程度、病程及CKD分期者,其在希望水平和自我管理状况方面差异均无统计学意义(P均>0.05)。年龄及婚姻状况与患者自我效能有关,年龄大于65岁者自我效能明显高于其他年龄段患者(P均<0.05),已婚者自我效能明显高于单身者(P<0.05)。希望水平对自我效能(β=0.67,P<0.05)和自我管理均有直接影响效应(β=0.46,P<0.05)。结论CKD1~3期患者希望水平普遍较高。希望水平在一定程度上可影响患者的自我效能和自我管理状况。Objective To describe the status of hope,self-efficacy,and self-management in patients with chronic kidney disease(CKD)(stages 1- 3)and to explore the interactions between these three variables. Methods Herth Hope Index,self-efficacy scale,and CKD self-management instrument were used to evaluate the patients with CKD(stages 1- 3)in PUMC Hospital( n =153). Structural equation modeling was used to establish the structural equation model of hope,self-efficacy,and self-management. Results The median score of hope was 40.0(36.0,44.5),and 85.0% of patients were in higher level of hope. The median score of self-efficacy was 8.3(7.1,9.4)and the overall score of self-management was 89.0±13.4. There were no significant differences in level of hope and self-management among patients with different age,gender,marital status,educational level,course of disease,and CKD stages(all P >0.05). Age and marriage status were significantly associated with self-efficacy. Self-efficacy was significantly higher in >65 years group than in other age groups( P <0.05)and was significantly higher in married group than in single group( P <0.05).The level of hope had direct effect on self-efficacy(β=0.67, P <0.05)and self-management(β=0.46, P <0.05). Conclusions The levels of hope,self-efficacy,and self-management are high in patients with CKD(stages 1- 3). Hope directly affects the self-efficacy and self-management of these patients.

关 键 词：慢性肾脏病 希望 自我效能 自我管理 

分 类 号：R473.5[医药卫生—护理学]