居家腹膜透析患者液体限制依从性及影响因素  

The level and determinants of adherence to fluid restrictions in patients undergoing home peritoneal dialysis

作　　者：张静 田素革 顾玥 郑艳平 张丽娜 Zhang Jing;Tian Suge;Gu Yue;Zheng Yanping;Zhang Lina(Department of Nephrology,Henan Provincial People′s Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院肾内科/河南省肾脏病免疫重点实验室/郑州大学人民医院,河南郑州450000

出　　处：《护理学杂志》2020年第17期24-28,共5页Journal of Nursing Science

基　　金：国家重点研发计划资助项目(2018YFC0114503);河南省医学科技攻关项目(201503149)。

摘　　要：目的评估居家腹膜透析患者液体限制依从性状况并分析其影响因素。方法对167例居家腹膜透析患者,采用中文版尿毒症期腹膜透析患者依从性问卷中液体限制依从性进行调查,分析基本资料对液体限制依从性的影响;采用半结构式访谈15例患者,深入探索其依从性差的原因,通过内容分析法总结访谈资料。结果66.5%的居家腹膜透析患者依从性好,33.5%患者依从性差;Logistic回归分析结果显示,性别、年龄、透析龄是液体限制依从性的影响因素(P<0.05,P<0.01);液体限制依从性差的原因可归为认知不足、态度消极、计算液体摄入量麻烦和困难、负性感受和客观因素5个主题。结论PD患者液体限制依从性有待提高;液体限制依从性影响因素多样,医护人员需针对性制定措施提高患者依从性。Objective To determine the level and factors associated with adherence to fluid restrictions among patients who underwent home peritoneal dialysis.Methods A total of 167 patients undergoing home peritoneal dialysis were investigated in terms of their adherence to fluid restrictions and the impact of demographic data on adherence to fluid restrictions was analyzed.Semi-structured interviews were conducted on 15 patients to identify the causes of non-adherence,then data were analyzed using content analysis.Results Two-thirds of patients(66.5%)were adherent to fluid restrictions,while 33.5%of them reported poor level of adherence.Logistic regression analysis showed that gender,age and duration of peritoneal dialysis were factors associated with adherence to fluid restrictions(P<0.05,P<0.01).The reasons for poor adherence could be summarized into 5 themes:unawareness of fluid restrictions,negative attitude,having trouble or difficulty in fluid intake volume calculation,negative feelings,and objective factors.Conclusion Adherence to fluid restrictions in peritoneal dialysis patients needs to be enhanced and is affected by multiple factors.Targeted intervention should be provided to improve their adherence.

关 键 词：腹膜透析 居家 液体限制 依从性 影响因素 

分 类 号：R473.2[医药卫生—护理学] R459.5[医药卫生—临床医学]