维持性血液透析患者疲乏影响因素及其与心理弹性、希望之间的相关性分析  

Influencing factors of fatigue in in maintenance hemodialysis patients and their correlation with psychological resilience and hope

作　　者：侯瑞[1] 宋明芬[2] 亢俊俊 郭艳香[3] HOU Rui;SONG Ming-fen;KANG Jun-jun;GUO Yan-xiang(Department of Psychosomatic Medicine,the Seventh People's Hospital in Hangzhou,Hangzhou,Zhejiang 310000,China;不详)

机构地区：[1]杭州市第七人民医院心身二科,浙江杭州310000 [2]杭州市第七人民医院分子生物学实验室,浙江杭州310000 [3]杭州市中医院肾病科,浙江杭州310000

出　　处：《中华全科医学》2021年第2期266-269,共4页Chinese Journal of General Practice

基　　金：国家自然科学青年基金(81601183)。

摘　　要：目的了解维持性血液透析(MHD)患者的心理弹性、希望和疲乏现状,分析心理弹性在希望与疲乏之间的作用。方法采用便利抽样方法,于2019年9—10月选择杭州市中医院肾病科符合纳入排除标准的120例MHD患者进行问卷调查,调查问卷包括患者一般资料调查表、Piper疲乏修订量表、Herth希望量表及心理弹性量表,调查人员采用统一指导语进行一对一调查,最终获得有效问卷114份,采用统计软件对调查结果进行分析。结果维持性血液透析患者疲乏得分为(5.74±0.84)分,处于中等水平。希望得分为(33.97±3.45)分,处于中等偏高水平。心理弹性得分为(51.48±7.71)分,处于较低水平。不同年龄和血红蛋白含量的患者疲乏评分差异有统计学意义(均P<0.01),其中年龄>65岁的患者疲乏得分最高,血红蛋白含量<100 g/L的患者疲乏得分最高。希望得分与疲乏得分呈负相关(r=-0.374,P<0.01);心理弹性得分与希望得分呈正相关(r=0.342,P<0.01),与疲乏得分呈负相关(r=-0.624,P<0.01)。心理弹性在患者希望与疲乏间存在中介效应(P<0.01),中介效应占总效应的比值为13.4%。结论维持性血液透析患者的疲乏状况亟须改善,希望是影响疲乏的重要因素,且心理弹性在其中发挥中介作用。Objective To understand the psychological resilience, hope and fatigue of maintenance hemodialysis(MHD) patients, and to analyze the role of psychological resilience in patients’ hope and fatigue. Methods Using convenient sampling technique, 120 maintenance hemodialysis patients who met the inclusion exclusion criteria in department of nephrology of Hospital of Traditional Chinese Medicine of Hangzhou City were selected for the questionnaire survey from September to October 2019. The questionnaire included patients’ general information questionnaire, Revised Piper Fatigue Scale(RPFS), Herth Hope Index(HHI), Connor-Davidson Resilience Scale(CD-RISC). The investigators conducted one-to-one survey with unified guidance, and finally obtained 114 valid questionnaires were returned, Statistical software was used to analyze the survey result. Results Fatigue scores of the MHD patients was(5.74±0.84), which is at medium level. The hope score is(33.97±3.45), which is on the high side of the medium level. The psychological resilience score was(51.48±7.71), which was at a low level. The fatigue scores of patients with different ages and hemoglobin level were statistically significant(all P<0.01). Among them, patients aged >65 years old had the highest the highest fatigue score, and patients with hemoglobin level<100 g/L had the highest fatigue score. Hope score was negatively correlated with fatigue score(r=-0.374, P<0.01). Resilience score was positively correlated with hope score(r=0.342, P<0.01) and negatively correlated with fatigue score(r=-0.624, P<0.01). psychological resilience played a mediating role between hope and fatigue(P<0.01), and the ratio of mediating effect to total effect was 13.4%. Conclusion The fatigue status of MHD patients needs to be improved urgently. The hope is an important factor affecting fatigue, and the mental resilience plays a mediating role.

关 键 词：维持性血液透析 心理弹性 希望 疲乏 中介效应 

分 类 号：R459.5[医药卫生—治疗学] R395.6[医药卫生—临床医学]