维持性血液透析患者焦虑状态与不依从性的相关性分析  

Corelation between anxiety and non-compliance among maintenance hemodialysis patients

作　　者：丁霞 耿培宏[1] 熊云锦 杨洋[2] 刘晴 程卫华[2] 张寅[1] 刘婧 王冬雪[1] 龚勇[1] 王春雪[2] 周亦伦[1] Ding Xia;Geng Peihong;Xiong Yunjin;Yang Yang;Liu Qing;Cheng Weihua;Zhang Yin;Liu Jing;Wang Dongxue;Gong Yong;Wang Chunxue;Zhou Yilun(Department of Nephrology,Beijing Tiantan Hospital,Capital Medical University,Beijingl00070,China)

机构地区：[1]首都医科大学附属北京天坛医院肾内科,100070 [2]首都医科大学附属北京天坛医院神经精神医学与临床心理科,100070

出　　处：《北京医学》2021年第6期517-520,共4页Beijing Medical Journal

摘　　要：目的通过对维持性血液透析患者的横断面研究,探讨患者焦虑状态和不依从性的患病率及两者的相关性。方法选取2019年1—7月在首都医科大学附属北京天坛医院血液净化中心接受维持性血液透析治疗的患者,应用Zung氏焦虑自评量表(self-rating anxiety scale, SAS)对患者进行测评,收集患者透析间期体质量增长/干体质量(%)、透析前血钾等数据,分析液体限制不依从性、饮食钾限制不依从性、总体不依从性与焦虑状态之间的相关性。结果最终纳入的82例患者中有焦虑状态者占15.9%(13/82),液体限制不依从者占14.6%(12/82),饮食钾限制不依从者占18.3%(15/82),总体不依从者占29.3%(24/82)。焦虑状态患者与非焦虑状态患者相比,液体限制不依从性(38.5%比10.1%,P=0.019)及总体不依从性(53.8%比24.6%, P=0.047)比例均明显偏高。多因素logistics回归分析显示,焦虑状态是液体限制不依从性(OR=5.71, 95%CI:1.0730.38)的独立影响因素。结论维持性血液透析患者中焦虑状态、不依从性并不少见;焦虑状态是液体限制不依从性的独立影响因素。关注并改善患者精神状态,有潜在临床意义。Objective To study the prevalence of anxiety state and non-compliance and their correlation among patients on hemodialysis. Methods Eighty-two maintenance hemodialysis patients in Department of Nephrology, Beijing Tiantan Hospital, from January to July 2019 were assessed anxiety state with the Zung self-rating anxiety scale. Noncompliance was defined as non-adherence to fluid restriction, dietary potassium restriction and total non-adherence. Data were analyzed by t test, Chi-square test and logistics analysis using the software SPSS. Results There were 15.9% patients diagnosed with anxiety state. The percentages of non-compliance to fluid restriction, non-compliance to dietary potassium restriction and total non-compliance were 14.6%, 18.3%, 29.3%, respectively. Patients diagnosed with anxiety state were more likely to have fluid control problems(38.5% vs. 10.1%, P = 0.019) and be totally non-compliant(53.8% vs. 24.6%, P = 0.047)when they were compared with non-anxious patients. Anxiety was related with non-compliance to fluid restriction(OR = 5.71,95% CI: 1.07-30.38). Conclusions Anxiety state and non-compliance are common among hemodialysis patients. Anxiety state is associated with non-compliance significantly. It may be of great significance to pay attention to and improve the mental state of patients in clinical work.

关 键 词：维持性血液透析 焦虑状态 液体限制不依从性 饮食钾限制不依从性 

分 类 号：R692.5[医药卫生—泌尿科学]